Centreville Pediatric Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CENTREVILLE PEDIATRIC DENTISTRY PLLC

Practice address

14701 Lee Hwy
Ste 107-108
Centreville, VA 20121-2137

Phone

(757) 869-9916

Fax

(757) 898-4919

NPI assigned

Nov 18, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chris Cannon

Title

RCM

Phone

(757) 869-9916

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1720948052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 KILN CREEK PKWY",
            "address_2": "STE P",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013651",
            "telephone_number": "757-869-9916",
            "fax_number": "757-898-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 LEE HWY",
            "address_2": "STE 107-108",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212137",
            "telephone_number": "757-869-9916",
            "fax_number": "757-898-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTREVILLE PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "757-869-9916"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Centreville Family Chiropractic
• Centreville Family Practice
• Centreville Internal Medicine
• Centreville Medical Practice PLLC
• Centreville Optometry, LLC
• Centreville Physical Therapy, PC
• Centreville Women'S Health LLC
• Centreville-Chantilly Family Practice
• Navneen Chahal, PA-C
• Jose Rodrigo Charcon, PTA

• Pediatric Dentistry in Centreville, VA
• Providers in Centreville, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.