{
"Npi": {
"NPI": "1417016866",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "EINERSON",
"FirstName": "LOWELL",
"MiddleName": "EVERETT",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1400 HAWTHORNE",
"SecondLineMailingAddress": "SUITE 1",
"MailingAddressCityName": "ALEXANDRIA",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "56308",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "320-763-3445",
"MailingAddressFaxNumber": "320-763-5994",
"FirstLinePracticeLocationAddress": "1400 HAWTHORNE",
"SecondLinePracticeLocationAddress": "SUITE 1",
"PracticeLocationAddressCityName": "ALEXANDRIA",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "56308",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "320-763-3445",
"PracticeLocationAddressFaxNumber": "320-763-5994",
"EnumerationDate": "12/08/2006",
"LastUpdateDate": "12/13/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "9227",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "9227",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}