{
"Npi": {
"NPI": "1285819243",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PETERS",
"FirstName": "OVE",
"MiddleName": "ANDREAS",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DMD MS PHD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "239 CALIFORNIA AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILL VALLEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94941-3553",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "415-383-7378",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "155 5TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN FRANCISCO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94103-2919",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "415-351-7117",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/08/2008",
"LastUpdateDate": "10/16/2015",
"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": "1223E0200X",
"TaxonomyName": "Endodontics",
"LicenseNumber": "56127",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}