{
"Npi": {
"NPI": "1043104292",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HARDIK PATEL DDS PA",
"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": "1080 NEWTON CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCKLEDGE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32955-4571",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "229-364-6350",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1127 N COURTENAY PKWY # 5514",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERRITT ISLAND",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32953-5514",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "321-452-4988",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/04/2025",
"LastUpdateDate": "06/04/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATEL",
"AuthorizedOfficialFirstName": "HARDIK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "229-364-6350",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}