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1023153020 NPI number — CAROLINE WEISSMAN DERROW DDS

NPI Number: 1023153020
Health Care Provider/Practitioner: CAROLINE WEISSMAN DERROW DDS

Information about “1023153020” NPI (CAROLINE WEISSMAN DERROW DDS) exists in 1023153020 in HTML format HTML  |  1023153020 in plain Text format TXT  |  1023153020 in PDF (Portable Document Format) PDF  |  1023153020 in an XML format XML  formats.

NPI Number : 1023153020 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023153020",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DERROW",
    "FirstName": "CAROLINE",
    "MiddleName": "WEISSMAN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1005 NICHOLAS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUBURN",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46706-3635",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "260-927-0707",
    "MailingAddressFaxNumber": "260-927-0808",
    "FirstLinePracticeLocationAddress": "1005 NICHOLAS ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUBURN",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46706-3635",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "260-927-7070",
    "PracticeLocationAddressFaxNumber": "260-927-0808",
    "EnumerationDate": "02/20/2007",
    "LastUpdateDate": "07/15/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223P0221X",
        "TaxonomyName": "Pediatric Dentistry",
        "LicenseNumber": "12010667A",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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