{
"Npi": {
"NPI": "1306257134",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OPHEIM",
"FirstName": "KARA",
"MiddleName": "L",
"NamePrefix": "MISS",
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1835 BROADWAY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MELROSE PARK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60160-2040",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-548-3727",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1355 EDGEWATER ST NW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SALEM",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97304-4077",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-588-6960",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/14/2014",
"LastUpdateDate": "10/03/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "019.030570",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}