{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "R & C DENTAL, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 330",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WHITE MARSH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23183-0330",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-684-9905",
"MailingAddressFaxNumber": "804-684-3669",
"FirstLinePracticeLocationAddress": "4121 GEORGE WASHINGTON MEMORIAL HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAYES",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23072-2931",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-684-9905",
"PracticeLocationAddressFaxNumber": "804-684-3669",
"EnumerationDate": "04/29/2008",
"LastUpdateDate": "09/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BONESTEEL",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "P.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "804-684-9905",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "BB3838969",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}