{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "J FAMILY DENTAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "16521 NW 77TH PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIAMI LAKES",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33016-8417",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-302-8046",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2438 W 60TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HIALEAH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33016-4400",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-558-6832",
"PracticeLocationAddressFaxNumber": "305-558-1159",
"EnumerationDate": "01/04/2025",
"LastUpdateDate": "01/04/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATINO",
"AuthorizedOfficialFirstName": "JOELYZ",
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"AuthorizedOfficialTitle": "MGR",
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"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "786-217-2058",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}