{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BEACON WOODS FAMILY DENTISTRY PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12036 COBBLESTONE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUDSON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34667-2413",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12036 COBBLESTONE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUDSON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34667-2413",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-862-7664",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/08/2015",
"LastUpdateDate": "01/08/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KHAN",
"AuthorizedOfficialFirstName": "ABDUL",
"AuthorizedOfficialMiddleName": "HAMEED",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "727-364-5697",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "9928",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}