{
"Npi": {
"NPI": "1205146024",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RELEFORD ORTHODONTIC CENTER, INC",
"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": "6535 W CAMELBACK RD",
"SecondLineMailingAddress": "SUITE 5",
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85033",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-245-9753",
"MailingAddressFaxNumber": "623-245-9755",
"FirstLinePracticeLocationAddress": "6535 W CAMELBACK RD",
"SecondLinePracticeLocationAddress": "SUITE 5",
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85033-1608",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-245-9753",
"PracticeLocationAddressFaxNumber": "623-245-9755",
"EnumerationDate": "10/14/2010",
"LastUpdateDate": "10/14/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RELEFORD",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "DALE",
"AuthorizedOfficialTitle": "OWNER/ORTHODONTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "623-245-9753",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "D6576",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}