{
"Npi": {
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DELMAR DENTAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9320 ANNAPOLIS RD STE 101",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LANHAM",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20706-3128",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-577-6002",
"MailingAddressFaxNumber": "301-577-7267",
"FirstLinePracticeLocationAddress": "9320 ANNAPOLIS RD STE 101",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LANHAM",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20706-3128",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-577-6002",
"PracticeLocationAddressFaxNumber": "301-577-7267",
"EnumerationDate": "03/09/2010",
"LastUpdateDate": "12/16/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GEORGE",
"AuthorizedOfficialFirstName": "DELPHINE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTIST/ OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "301-577-6002",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "13836",
"LicenseNumberStateCode": "MD",
"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."
}
}
}
}