{
"Npi": {
"NPI": "1356497499",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HILLOCK",
"FirstName": "DONALD",
"MiddleName": "LEE",
"NamePrefix": "DR.",
"NameSuffix": "JR.",
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1908 COFFEE RD.",
"SecondLineMailingAddress": "BLGD. 4",
"MailingAddressCityName": "MODESTO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95355",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-522-8800",
"MailingAddressFaxNumber": "209-522-5126",
"FirstLinePracticeLocationAddress": "1908 COFFEE RD.",
"SecondLinePracticeLocationAddress": "BLDG. 4",
"PracticeLocationAddressCityName": "MODESTO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95355",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-522-8800",
"PracticeLocationAddressFaxNumber": "209-522-5126",
"EnumerationDate": "01/25/2007",
"LastUpdateDate": "04/14/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "30787",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}