{
"Npi": {
"NPI": "1336425651",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DYNASTY DENTAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "717 S GREENVILLE AVE",
"SecondLineMailingAddress": "#114",
"MailingAddressCityName": "ALLEN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75002-3317",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-547-8628",
"MailingAddressFaxNumber": "214-547-8675",
"FirstLinePracticeLocationAddress": "717 S GREENVILLE AVE",
"SecondLinePracticeLocationAddress": "#114",
"PracticeLocationAddressCityName": "ALLEN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75002-3317",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-547-8628",
"PracticeLocationAddressFaxNumber": "214-547-8675",
"EnumerationDate": "11/01/2011",
"LastUpdateDate": "11/01/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRAN",
"AuthorizedOfficialFirstName": "JANET",
"AuthorizedOfficialMiddleName": "DIEM",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "214-547-8628",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "20556",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}