{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "HIGH MOUNTAIN HYGIENE, PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 967",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FAIRPLAY",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80440-0967",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "719-836-0967",
"MailingAddressFaxNumber": "719-836-0967",
"FirstLinePracticeLocationAddress": "548 FRONT ST.",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "FAIRPLAY",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80440",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "719-836-0967",
"PracticeLocationAddressFaxNumber": "719-836-0967",
"EnumerationDate": "05/01/2013",
"LastUpdateDate": "05/03/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUTLER-BEARZI",
"AuthorizedOfficialFirstName": "MARTA",
"AuthorizedOfficialMiddleName": "SUE",
"AuthorizedOfficialTitle": "OWNER/SOLE PROPRIETOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RDH",
"AuthorizedOfficialTelephoneNumber": "719-836-0967",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "124Q00000X",
"TaxonomyName": "Dental Hygienist",
"LicenseNumber": "200621",
"LicenseNumberStateCode": "CO",
"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."
}
}
}
}