{
"Npi": {
"NPI": "1275678963",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DOLBERG",
"FirstName": "DAVID",
"MiddleName": "BARRY",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.C.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NORMANDY-DOLBERG",
"OtherFirstName": "DAVID",
"OtherMiddleName": "BARRY",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "D.C.",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "8440 OLD KEENE MILL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPRINGFIELD",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22152-2302",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "703-569-1300",
"MailingAddressFaxNumber": "703-569-1972",
"FirstLinePracticeLocationAddress": "8440 OLD KEENE MILL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPRINGFIELD",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22152-2302",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "703-569-1300",
"PracticeLocationAddressFaxNumber": "703-569-1972",
"EnumerationDate": "02/20/2007",
"LastUpdateDate": "07/08/2007",
"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": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "0104000354",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}