{
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"OrgName": "PRAIRIE VISTA FAMILY DENTAL",
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"FirstLineMailingAddress": "235 W FLETCHER ST",
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"MailingAddressCityName": "HAXTUN",
"MailingAddressStateName": "CO",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "235 W FLETCHER ST",
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"EnumerationDate": "01/24/2014",
"LastUpdateDate": "01/24/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCARPELLA",
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"AuthorizedOfficialMiddleName": "W",
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"AuthorizedOfficialCredential": "D.D.S.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dentist",
"LicenseNumber": "106313",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}