NPIMap

Organization Active NPI

Andrew W Henritze DDS PLLC

  • Dental Clinic/Center
  • Roanoke, VA
National Provider Identifier
1104533660
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ANDREW W HENRITZE DDS PLLC
Practice address
3611 Brambleton Ave
Roanoke, VA 24018-3611
Phone
(540) 991-5151
Fax
(540) 202-9339
NPI assigned
Nov 3, 2022
Organization subpart
Yes
Parent organization
ANDREW W HENRITZE DDS PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Rebecca Hawkins Harris
Title
Accounts Receiveable Analyst
Phone
(544) 077-6655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3611 Brambleton Ave
Roanoke, VA 24018-3611

Mailing address

PO Box 52492
Phoenix, AZ 85072-2492

Other names 1

  • Southwest Virginia Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Andrew W Henritze DDS PLLC2 organizations share this tax ID, including this one
Part of
Andrew W Henritze DDS PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1104533660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52492",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850722492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183611",
            "telephone_number": "540-991-5151",
            "fax_number": "540-202-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW W HENRITZE DDS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANDREW W HENRITZE DDS PLLC",
        "enumeration_date": "2022-11-03",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "HAWKINS",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVEABLE ANALYST",
        "authorized_official_telephone_number": "544-077-6655"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Virginia Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwest Virginia Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.