{
"Npi": {
"NPI": "1356649347",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JAY A BAUER DDS PC",
"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": "923 1ST STREET S",
"SecondLineMailingAddress": "PO BOX 139",
"MailingAddressCityName": "CARRINGTON",
"MailingAddressStateName": "ND",
"MailingAddressPostalCode": "58421-0139",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "701-652-2801",
"MailingAddressFaxNumber": "701-652-2802",
"FirstLinePracticeLocationAddress": "923 1ST ST S",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CARRINGTON",
"PracticeLocationAddressStateName": "ND",
"PracticeLocationAddressPostalCode": "58421-2034",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "701-652-2801",
"PracticeLocationAddressFaxNumber": "701-652-2802",
"EnumerationDate": "03/01/2011",
"LastUpdateDate": "03/01/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAUER",
"AuthorizedOfficialFirstName": "JAY",
"AuthorizedOfficialMiddleName": "ALLEN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "701-652-2801",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}