{
"Npi": {
"NPI": "1417260787",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RIDGEVIEW PEDIATRIC DENTISTRY PC",
"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": "14697 DELAWARE ST",
"SecondLineMailingAddress": "BLDG. B, SUITE #210",
"MailingAddressCityName": "WESTMINSTER",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80023-9178",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-650-0310",
"MailingAddressFaxNumber": "303-650-0311",
"FirstLinePracticeLocationAddress": "14697 DELAWARE ST",
"SecondLinePracticeLocationAddress": "BLDG. B, SUITE #210",
"PracticeLocationAddressCityName": "WESTMINSTER",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80023-9178",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "303-650-0310",
"PracticeLocationAddressFaxNumber": "303-650-0311",
"EnumerationDate": "07/15/2010",
"LastUpdateDate": "07/15/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MUDD",
"AuthorizedOfficialFirstName": "CARA",
"AuthorizedOfficialMiddleName": "LYNN",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS, MSD",
"AuthorizedOfficialTelephoneNumber": "303-650-0310",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "8289",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}