{
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"OrgName": "DENTAL DOCTORS OF NJ",
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"NamePrefix": null,
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"FirstLineMailingAddress": "136 WASHINGTON AVE",
"SecondLineMailingAddress": "1ST FLR",
"MailingAddressCityName": "BELLEVILLE",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07109-2926",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "136 WASHINGTON AVE",
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"EnumerationDate": "06/13/2013",
"LastUpdateDate": "06/13/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FLYNN-NYKTAS",
"AuthorizedOfficialFirstName": "DEBORAH",
"AuthorizedOfficialMiddleName": "A.",
"AuthorizedOfficialTitle": "DENTIST",
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"AuthorizedOfficialCredential": "DMD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "22DI01712800",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}