{
"Npi": {
"NPI": "1396240354",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WILLIAM G. ZIECINA, D.D.S., P.C.",
"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": "22025 HOMESTEAD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MACOMB",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48044-2333",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-709-0777",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "52975 VAN DYKE AVE STE 303",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SHELBY TOWNSHIP",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48316-3544",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-709-0777",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/29/2018",
"LastUpdateDate": "03/29/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHASSE",
"AuthorizedOfficialFirstName": "JENNIFER",
"AuthorizedOfficialMiddleName": "SUZANNE",
"AuthorizedOfficialTitle": "INSURANCE COORDINATOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "248-219-7722",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "273504940",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}