{
"Npi": {
"NPI": "1023204187",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "YANCY T. SIPES DDS PS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "31527 3RD AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BLACK DIAMOND",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98010-9731",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-886-1300",
"MailingAddressFaxNumber": "360-886-9848",
"FirstLinePracticeLocationAddress": "31527 3RD AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLACK DIAMOND",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98010-9731",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-886-1300",
"PracticeLocationAddressFaxNumber": "360-886-9848",
"EnumerationDate": "09/21/2007",
"LastUpdateDate": "09/21/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIPES",
"AuthorizedOfficialFirstName": "YANCY",
"AuthorizedOfficialMiddleName": "THEODORE",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "360-886-1300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DE0009945",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}