{
"Npi": {
"NPI": "1235158825",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GRIFFITH",
"FirstName": "JOHJANNIESMAGNO",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 56015",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAYAMON",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00960-6215",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-858-5060",
"MailingAddressFaxNumber": "787-784-2427",
"FirstLinePracticeLocationAddress": "E3 CARR 155",
"SecondLinePracticeLocationAddress": "URBANISACION BRAZILIA",
"PracticeLocationAddressCityName": "VEGA BAJA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00693-4673",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-858-5060",
"PracticeLocationAddressFaxNumber": "787-784-2427",
"EnumerationDate": "07/18/2006",
"LastUpdateDate": "08/26/2015",
"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": "1223S0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "1216",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}