{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "RICHARD L. TRIPPIE, D.D.S. AND RALPH A. TRAYLOR, D.D.S., L.L.P.",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"FirstLineMailingAddress": "4001 GARTH RD",
"SecondLineMailingAddress": "SUITE 104",
"MailingAddressCityName": "BAYTOWN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77521-3115",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-427-4736",
"MailingAddressFaxNumber": "281-427-7127",
"FirstLinePracticeLocationAddress": "4001 GARTH RD",
"SecondLinePracticeLocationAddress": "SUITE 104",
"PracticeLocationAddressCityName": "BAYTOWN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77521-3115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-427-4736",
"PracticeLocationAddressFaxNumber": "281-427-7127",
"EnumerationDate": "05/26/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TRIPPIE",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "PARTNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "281-427-4736",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223P0221X",
"TaxonomyName": "Pediatric Dentistry",
"LicenseNumber": "10177",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}