{
"Npi": {
"NPI": "1225154636",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SCHNEEKLUTH",
"FirstName": "CLARK",
"MiddleName": "E.",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS, MS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2642 VISTA ORNADA",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWPORT BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92660-3540",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-898-3308",
"MailingAddressFaxNumber": "714-894-0588",
"FirstLinePracticeLocationAddress": "5253 LAMPSON AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GARDEN GROVE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92845-1953",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-898-3308",
"PracticeLocationAddressFaxNumber": "714-894-0588",
"EnumerationDate": "03/21/2007",
"LastUpdateDate": "07/08/2007",
"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": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "30693",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}