Provider Demographics
NPI:1881022499
Name:BURRISS, ANDREW RYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RYAN
Last Name:BURRISS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 FOREST AVE
Mailing Address - Street 2:SUITE110
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1729
Mailing Address - Country:US
Mailing Address - Phone:804-893-8692
Mailing Address - Fax:
Practice Address - Street 1:6900 FOREST AVE
Practice Address - Street 2:SUITE110
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1729
Practice Address - Country:US
Practice Address - Phone:804-893-8692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9765122300000X
VA04420002451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist