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1215282298 NPI number — MELANIE CECILE CHURINETZ DDS

NPI Number: 1215282298
Health Care Provider/Practitioner: MELANIE CECILE CHURINETZ DDS

Information about “1215282298” NPI (MELANIE CECILE CHURINETZ DDS) exists in 1215282298 in HTML format HTML  |  1215282298 in plain Text format TXT  |  1215282298 in PDF (Portable Document Format) PDF  |  1215282298 in an XML format XML  formats.

NPI Number : 1215282298 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215282298",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHURINETZ",
    "FirstName": "MELANIE",
    "MiddleName": "CECILE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SHOEMAKER",
    "OtherFirstName": "MELANIE",
    "OtherMiddleName": "CECILE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "833 N. ACADEMY BOULEVARD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLORADO SPRINGS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80909",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "719-442-0071",
    "MailingAddressFaxNumber": "719-473-5303",
    "FirstLinePracticeLocationAddress": "833 NORTH ACADEMY BOULEVARD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLORADO SPRINGS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80909",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "719-442-0071",
    "PracticeLocationAddressFaxNumber": "719-473-5303",
    "EnumerationDate": "07/17/2012",
    "LastUpdateDate": "04/28/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "00202412",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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