{
"Npi": {
"NPI": "1073061693",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PHILIP R. HOWARD DDS AND TARA M. SULLIVAN DDS, PLLC",
"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": "4520 42ND AVE SW STE 23",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SEATTLE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98116-4240",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-938-1777",
"MailingAddressFaxNumber": "206-938-0740",
"FirstLinePracticeLocationAddress": "4520 42ND AVE SW STE 23",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SEATTLE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98116-4240",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-938-1777",
"PracticeLocationAddressFaxNumber": "206-938-0740",
"EnumerationDate": "09/12/2016",
"LastUpdateDate": "09/12/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOWARD",
"AuthorizedOfficialFirstName": "PHILIP",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "206-938-1777",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "DE00010978",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}