{
"Npi": {
"NPI": "1396173704",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRADLEY S. MOTT, DDS, PLLC",
"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": "6507 NE 181ST ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KENMORE",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98028-4801",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "425-486-9211",
"MailingAddressFaxNumber": "425-402-1093",
"FirstLinePracticeLocationAddress": "6507 NE 181ST ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KENMORE",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98028-4801",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "425-486-9211",
"PracticeLocationAddressFaxNumber": "425-402-1093",
"EnumerationDate": "10/22/2013",
"LastUpdateDate": "01/01/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOTT",
"AuthorizedOfficialFirstName": "BRADLEY",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "MEMBER, MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "763-227-5222",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DE60091370",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}