{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "NENI SHRIVER,DDS INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7817 IVANHOE AVE",
"SecondLineMailingAddress": "STE 304",
"MailingAddressCityName": "LA JOLLA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92037-4559",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "858-456-4442",
"MailingAddressFaxNumber": "858-456-4443",
"FirstLinePracticeLocationAddress": "7817 IVANHOE AVE",
"SecondLinePracticeLocationAddress": "STE 304",
"PracticeLocationAddressCityName": "LA JOLLA",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "858-456-4442",
"PracticeLocationAddressFaxNumber": "858-456-4443",
"EnumerationDate": "02/08/2012",
"LastUpdateDate": "02/21/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHRIVER",
"AuthorizedOfficialFirstName": "NENI",
"AuthorizedOfficialMiddleName": "DIAH",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "858-456-4442",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "45194",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}