{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "CHARLES S. TIU, DDS,PC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "617 MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "METUCHEN",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08840-1403",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-548-2691",
"MailingAddressFaxNumber": "732-548-2695",
"FirstLinePracticeLocationAddress": "617 MAIN ST",
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"PracticeLocationAddressCityName": "METUCHEN",
"PracticeLocationAddressStateName": "NJ",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-548-2691",
"PracticeLocationAddressFaxNumber": "732-548-2695",
"EnumerationDate": "04/24/2008",
"LastUpdateDate": "04/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TIU",
"AuthorizedOfficialFirstName": "CHARLES",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "732-548-2691",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "22DI01818800",
"LicenseNumberStateCode": "NJ",
"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."
}
}
}
}