Individual provider Active NPI

Andrew Henry, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Charlotte, NC
National Provider Identifier
1013278696
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN1858214 Issued in MA
Practice address
8840 Blakeney Professional Dr Ste 300
Charlotte, NC 28277-6749
Phone
(704) 347-3900
NPI assigned
May 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN1858214 MA Primary

Addresses

Primary practice location

8840 Blakeney Professional Dr Ste 300
Charlotte, NC 28277-6749

Mailing address

802 Sharview Cir Apt 1138
Charlotte, NC 28217-0090
Phone (419) 215-7136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190904001466 MA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 8325347016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Univ of Pennsylvania School of Dental Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Boston UniversityGroup PAC ID 8921070822, 43 clinicians

Practice addresses (Care Compare)

100 E Newton St
G407
Boston, MA 02118-3552
Phone (617) 638-4350

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DN1858214MAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Boston University Oral and Maxillofacial Surgery CurrentSince Sep 1, 2019 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Trustees of Boston University Past Accepting new patients

Locations

100 East Newton St
#G407
Boston, MA 02118
Phone (617) 638-4350

725 Albany St
Boston, MA 02118
Phone (617) 414-4075

Interoperability endpoints

  • Direct secure messaging: ahenry119318@direct.bmc.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1013278696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 SHARVIEW CIR APT 1138",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282170090",
            "telephone_number": "419-215-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 BLAKENEY PROFESSIONAL DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776749",
            "telephone_number": "704-347-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ANDREW",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-31",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1858214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.