{
"Npi": {
"NPI": "1013391549",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LI",
"FirstName": "JASON",
"MiddleName": "Z",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LI",
"OtherFirstName": "ZHI",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "155 BORDEN AVE APT 21G",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LONG ISLAND CITY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11101-6238",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "646-407-8757",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6945 MYRTLE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLENDALE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11385-7265",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-821-4680",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/14/2015",
"LastUpdateDate": "04/25/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "058540",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}