{
"Npi": {
"NPI": "1215004627",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENNY BALES MD FACC 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": "1585 KAPIOLANI BLVD",
"SecondLineMailingAddress": "SUITE 1800",
"MailingAddressCityName": "HONOLULU",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96814-4522",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-521-7402",
"MailingAddressFaxNumber": "808-537-2094",
"FirstLinePracticeLocationAddress": "1380 LUSITANA ST",
"SecondLinePracticeLocationAddress": "SUITE 1002",
"PracticeLocationAddressCityName": "HONOLULU",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96813-2449",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-941-3363",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/29/2006",
"LastUpdateDate": "12/12/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BALES",
"AuthorizedOfficialFirstName": "DENNY",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "PROPRIETOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "808-521-7402",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "MD-4933",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}