{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "RHODA LOCKETT, DDS, PC",
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"NameSuffix": null,
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"FirstLineMailingAddress": "7017 CUMBRE VISTA WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLORADO SPRINGS",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80924-6028",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "719-694-8124",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3210 E WOODMEN RD",
"SecondLinePracticeLocationAddress": "#200",
"PracticeLocationAddressCityName": "COLORADO SPRINGS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80920-3588",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "719-358-6998",
"PracticeLocationAddressFaxNumber": "719-358-6952",
"EnumerationDate": "04/06/2015",
"LastUpdateDate": "04/06/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
"AuthorizedOfficialFirstName": "RHODA",
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"AuthorizedOfficialTitle": "ORTHODONTIST",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "240-338-2518",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "9800",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}