{
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"IsOrgSubpart": "N",
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"OrgName": "NATURAL SMILE DENTISTRY",
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"FirstName": null,
"MiddleName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10436 TRIANON PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WELLINGTON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33449-8074",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-596-7166",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "470 COLUMBIA DR STE E101",
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"PracticeLocationAddressCityName": "WEST PALM BEACH",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressTelephoneNumber": "561-656-5250",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/10/2010",
"LastUpdateDate": "09/06/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALVAREZ",
"AuthorizedOfficialFirstName": "JOSE",
"AuthorizedOfficialMiddleName": "FERNANDO",
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"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "18008",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}