{
"Npi": {
"NPI": "1407087729",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SEMPER DENTAL CENTER LLC",
"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": "9714 FRANKLIN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRANKLIN PARK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60131-1787",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-732-3408",
"MailingAddressFaxNumber": "773-925-9289",
"FirstLinePracticeLocationAddress": "9714 FRANKLIN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FRANKLIN PARK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60131-1787",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "773-732-3408",
"PracticeLocationAddressFaxNumber": "773-925-9289",
"EnumerationDate": "08/04/2009",
"LastUpdateDate": "08/04/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RENDON",
"AuthorizedOfficialFirstName": "VICTOR",
"AuthorizedOfficialMiddleName": "HUGO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "630-991-0437",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "019027752",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}