{
"Npi": {
"NPI": "1386830636",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MERTES",
"FirstName": "GREGORY",
"MiddleName": "CHRISTOPHER",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5655 HUDSON DR STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUDSON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44236-4454",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-655-5437",
"MailingAddressFaxNumber": "330-655-5435",
"FirstLinePracticeLocationAddress": "5655 HUDSON DR STE 300",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUDSON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44236-4454",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-655-5437",
"PracticeLocationAddressFaxNumber": "330-655-5435",
"EnumerationDate": "09/20/2007",
"LastUpdateDate": "09/20/2007",
"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": "1223P0221X",
"TaxonomyName": "Pediatric Dentistry",
"LicenseNumber": "3021515",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}