Active NPI
Andre Anthony Henriques, DDS
- Prosthodontics
- Danville, IL
National Provider Identifier
1700877438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 044564-1
- Practice address
- 1900 E Main St
Danville, IL 61832-5100 - Phone
- (719) 400-9031
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 044564-1 | NY | Primary |
Addresses
Primary practice location
1900 E Main St
Danville, IL 61832-5100
Mailing address
4849 Katelyn Dr
Indianapolis, IN 46228-7019
Phone (719) 400-9031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044564-1 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1700877438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4849 KATELYN DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462287019",
"telephone_number": "719-400-9031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 E MAIN ST",
"city": "DANVILLE",
"state": "IL",
"postal_code": "618325100",
"telephone_number": "719-400-9031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRIQUES",
"first_name": "ANDRE",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "044564-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.