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1245453208 NPI number — LILLIAN ROSE MITTL D.D.S.

NPI Number: 1245453208
Health Care Provider/Practitioner: LILLIAN ROSE MITTL D.D.S.

Information about “1245453208” NPI (LILLIAN ROSE MITTL D.D.S.) exists in 1245453208 in HTML format HTML  |  1245453208 in plain Text format TXT  |  1245453208 in PDF (Portable Document Format) PDF  |  1245453208 in an XML format XML  formats.

NPI Number : 1245453208 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245453208",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MITTL",
    "FirstName": "LILLIAN",
    "MiddleName": "ROSE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.D.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "305 E 24TH ST",
    "SecondLineMailingAddress": "APT. 19G",
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10010-4011",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "212-683-5736",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "160 E 32ND ST",
    "SecondLinePracticeLocationAddress": "SUITE 103",
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10016-6004",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-683-5736",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/10/2007",
    "LastUpdateDate": "07/08/2007",
    "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": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "35919",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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