{
"Npi": {
"NPI": "1174240105",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ORAGEN AURORA PC",
"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": "13701 E MISSISSIPPI AVE STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AURORA",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80012-6142",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-228-5453",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13701 E MISSISSIPPI AVE STE 300",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AURORA",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80012-6142",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-228-5453",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/20/2022",
"LastUpdateDate": "10/20/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAVICK",
"AuthorizedOfficialFirstName": "WHITNEY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SR. OPERATIONS MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "801-857-7947",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}