{
"Npi": {
"NPI": "1225481252",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JAMESTOWN FAMILY DENTISTRY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 844",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JAMESTOWN",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "38556-0844",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "931-879-9544",
"MailingAddressFaxNumber": "931-879-0844",
"FirstLinePracticeLocationAddress": "240 CENTRAL AVE W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JAMESTOWN",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "38556-3557",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "931-879-9544",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/14/2016",
"LastUpdateDate": "07/14/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEE",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": "SCOTT",
"AuthorizedOfficialTitle": "OWNER/MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "931-879-9544",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "10104",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}