1205099207 NPI number — FELIPE ARRUDA FALCAO D.D.S, M.S.

NPI Number: 1205099207
Health Care Provider/Practitioner: FELIPE ARRUDA FALCAO D.D.S, M.S.

NPI Number : 1205099207 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205099207",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FALCAO",
    "FirstName": "FELIPE",
    "MiddleName": "ARRUDA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.D.S, M.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3073 JACOB FIXEL CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32257-5889",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "904-778-3330",
    "MailingAddressFaxNumber": "904-778-3203",
    "FirstLinePracticeLocationAddress": "9590 APPLECROSS RD",
    "SecondLinePracticeLocationAddress": "STE 106",
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32222-5857",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-778-3330",
    "PracticeLocationAddressFaxNumber": "904-778-3203",
    "EnumerationDate": "07/09/2008",
    "LastUpdateDate": "05/21/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "F-24987",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "DN19579",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}