{
  "npi": "1710478110",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "REBECCA",
    "authorized_official_last_name": "HARRIS",
    "authorized_official_middle_name": "HAWKINS",
    "authorized_official_telephone_number": "5407766555",
    "authorized_official_title_or_position": "Accounts Receivable Analyst",
    "certification_date": "2025-06-18",
    "enumeration_date": "2018-05-22",
    "last_updated": "2025-06-18",
    "organization_name": "ANDREW W HENRITZE DDS PLLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "3611 BRAMBLETON AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ROANOKE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "888-817-9032",
      "postal_code": "240183611",
      "state": "VA",
      "telephone_number": "330-951-9153"
    },
    {
      "address_1": "PO BOX 52942",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "PHOENIX",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "888-817-9032",
      "postal_code": "850722942",
      "state": "AZ",
      "telephone_number": "330-951-9153"
    }
  ],
  "taxonomies": [
    {
      "code": "261QD0000X",
      "desc": "Clinic/Center, Dental",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "1223G0001X",
      "desc": "Dentist, General Practice",
      "license": "041008724",
      "primary": true,
      "state": "VA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)",
    "certifying_board": "American Dental Association (ADA) / State Board of Dental Examiners",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "C5",
        "medicare_type": "Dentist"
      }
    ]
  }
}