{
"Npi": {
"NPI": "1346500261",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REGIONAL DENTAL CENTERS, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "101 HARTH PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SUMMERVILLE",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29485-8107",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-875-5111",
"MailingAddressFaxNumber": "843-821-0532",
"FirstLinePracticeLocationAddress": "101 HARTH PL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SUMMERVILLE",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29485-8107",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-875-5111",
"PracticeLocationAddressFaxNumber": "843-821-0532",
"EnumerationDate": "05/24/2012",
"LastUpdateDate": "05/24/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POWERS",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "843-875-5111",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "2680",
"LicenseNumberStateCode": "SC",
"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."
}
}
}
}