{
"Npi": {
"NPI": "1184072555",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMES CENTER FOR COSMETIC AND FAMILY DENTISTRY 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": "415 S DUFF AVE STE D",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AMES",
"MailingAddressStateName": "IA",
"MailingAddressPostalCode": "50010-6600",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "515-956-3700",
"MailingAddressFaxNumber": "515-956-4232",
"FirstLinePracticeLocationAddress": "415 S DUFF AVE STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AMES",
"PracticeLocationAddressStateName": "IA",
"PracticeLocationAddressPostalCode": "50010-6600",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "515-956-3700",
"PracticeLocationAddressFaxNumber": "515-956-4232",
"EnumerationDate": "05/26/2016",
"LastUpdateDate": "10/12/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROCKOW-NELSON",
"AuthorizedOfficialFirstName": "AMIE",
"AuthorizedOfficialMiddleName": "J.",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "515-956-3700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BC3200X",
"TaxonomyName": "Customized Equipment (DME)",
"LicenseNumber": "08059",
"LicenseNumberStateCode": "IA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}