{
"Npi": {
"NPI": "1093048217",
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "ELECTRIC CITY DENTAL GROUP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"NameSuffix": null,
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"FirstLineMailingAddress": "305 SCHOOL SIDE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "THROOP",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18512-1456",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "570-383-0784",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "117 MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FOREST CITY",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18421-1440",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "570-785-3000",
"PracticeLocationAddressFaxNumber": "570-785-3175",
"EnumerationDate": "09/08/2009",
"LastUpdateDate": "09/08/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARTLAND",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": "II",
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "570-383-0784",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "DS035200",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}