{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOLDEN HILL FAMILY DENTISTRY",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11290 W ALAMEDA AVE",
"SecondLineMailingAddress": "SUITE A -100",
"MailingAddressCityName": "LAKEWOOD",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80226-2576",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-237-1553",
"MailingAddressFaxNumber": "303-232-1683",
"FirstLinePracticeLocationAddress": "11290 W ALAMEDA AVE",
"SecondLinePracticeLocationAddress": "SUITE A-100",
"PracticeLocationAddressCityName": "LAKEWOOD",
"PracticeLocationAddressStateName": "CO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-237-1553",
"PracticeLocationAddressFaxNumber": "303-232-1683",
"EnumerationDate": "04/14/2014",
"LastUpdateDate": "04/14/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "303-237-1553",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "DEN00105721",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}