{
"Npi": {
"NPI": "1295103729",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LISA M. MOTYL, DDS, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "999 HAYNES ST",
"SecondLineMailingAddress": "SUITE 285",
"MailingAddressCityName": "BIRMINGHAM",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48009-6712",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-540-3494",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "999 HAYNES ST",
"SecondLinePracticeLocationAddress": "SUITE 285",
"PracticeLocationAddressCityName": "BIRMINGHAM",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48009-6712",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-540-3494",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/15/2015",
"LastUpdateDate": "09/15/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOTYL",
"AuthorizedOfficialFirstName": "LISA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "248-540-3494",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "2901020555",
"LicenseNumberStateCode": "MI",
"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."
}
}
}
}