{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DIMITRIOS J. VARELDZIS DDS PLLC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "2399 PERSIMMON RDG",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOUDON",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37774-4773",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "865-378-0095",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "215 CENTER PARK DR STE 900",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KNOXVILLE",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "37922-2176",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "865-966-0500",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/20/2025",
"LastUpdateDate": "03/31/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VARELDZIS",
"AuthorizedOfficialFirstName": "DIMITRIOS",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}