{
"Npi": {
"NPI": "1043479421",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "NONE",
"ParentOrgTIN": null,
"OrgName": "FRANK F SUNSTROM DDS & JON L SUNSTROM DDS P.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "708 8TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOONE",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50036-2726",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "515-432-4223",
"MailingAddressFaxNumber": "515-432-1054",
"FirstLinePracticeLocationAddress": "708 8TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BOONE",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50036-2726",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "515-432-4223",
"PracticeLocationAddressFaxNumber": "515-432-1054",
"EnumerationDate": "06/02/2008",
"LastUpdateDate": "06/02/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUNSTROM",
"AuthorizedOfficialFirstName": "JON",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "515-432-4223",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "6579",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}