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1104417732 NPI number — GPS ADC OF JOPLIN AND DR. JOHN DURLING II, DDS, LLC

NPI Number: 1104417732
Health Care Provider/Practitioner: GPS ADC OF JOPLIN AND DR. JOHN DURLING II, DDS, LLC

Information about “1104417732” NPI (GPS ADC OF JOPLIN AND DR. JOHN DURLING II, DDS, LLC) exists in 1104417732 in HTML format HTML  |  1104417732 in plain Text format TXT  |  1104417732 in PDF (Portable Document Format) PDF  |  1104417732 in an XML format XML  formats.

NPI Number : 1104417732 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104417732",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GPS ADC OF JOPLIN AND DR. JOHN DURLING II, DDS, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "100 E HUNTINGTON AVE STE E",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JONESBORO",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72401-2900",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "870-243-4406",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2827 ARIZONA AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JOPLIN",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "64804-3102",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "417-208-3192",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/27/2021",
    "LastUpdateDate": "01/27/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LITTLE",
    "AuthorizedOfficialFirstName": "WILLIAM",
    "AuthorizedOfficialMiddleName": "R",
    "AuthorizedOfficialTitle": "CO-OWNER/PARTNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "870-243-4406",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QD0000X",
        "TaxonomyName": "Dental Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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