{
"Npi": {
"NPI": "1316490832",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "TORIN MARRACINO DDS, INC",
"ParentOrgTIN": null,
"OrgName": "PLEASANT GROVE FAMILY DENTISTRY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgNameTypeCode": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4330 MCKNIGHT RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TEXARKANA",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75503-0923",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "903-838-9700",
"MailingAddressFaxNumber": "903-832-3505",
"FirstLinePracticeLocationAddress": "4330 MCKNIGHT RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TEXARKANA",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75503-0923",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "903-838-9700",
"PracticeLocationAddressFaxNumber": "903-832-3505",
"EnumerationDate": "08/02/2016",
"LastUpdateDate": "08/02/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARRACINO",
"AuthorizedOfficialFirstName": "TORIN",
"AuthorizedOfficialMiddleName": "MICHAEL",
"AuthorizedOfficialTitle": "DENTIST/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "903-733-3390",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "31840",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}