{
"Npi": {
"NPI": "1366968711",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MELISSA M SCHOCK DDS LLC",
"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": "PO BOX 665",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FULLERTON",
"MailingAddressStateName": "NE",
"MailingAddressPostalCode": "68638-0665",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "308-536-2120",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "502 4TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FULLERTON",
"PracticeLocationAddressStateName": "NE",
"PracticeLocationAddressPostalCode": "68638-3119",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "308-536-2120",
"PracticeLocationAddressFaxNumber": "308-536-2559",
"EnumerationDate": "08/17/2017",
"LastUpdateDate": "01/09/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCHOCK",
"AuthorizedOfficialFirstName": "MELISSA",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "DR.",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "402-366-9507",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "7370",
"LicenseNumberStateCode": "NE",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}