{
"Npi": {
"NPI": "1255350369",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FLETCHER",
"FirstName": "GORDON",
"MiddleName": "EARL",
"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": "3737 S CLAIBORNE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW ORLEANS",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70125-4603",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "504-289-4602",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1904 HARDY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HATTIESBURG",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39401-4983",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-583-2250",
"PracticeLocationAddressFaxNumber": "601-583-2272",
"EnumerationDate": "07/19/2006",
"LastUpdateDate": "07/16/2013",
"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": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "3268-03",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "3515",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "1223P0221X",
"TaxonomyName": "Pediatric Dentistry",
"LicenseNumber": "PEDO3703",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}