{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "BELISARIO GARCIA-WILLIAMS D.D.S.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "4364 BONITA RD # 233",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BONITA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91902-1421",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "AVE PASEO DE LOS HEROES #9150-B",
"SecondLinePracticeLocationAddress": "ZONA URBANA RIO TIJUANA",
"PracticeLocationAddressCityName": "TIJUANA",
"PracticeLocationAddressStateName": "BAJA CALIFORNIA",
"PracticeLocationAddressPostalCode": "22010",
"PracticeLocationAddressCountryCode": "MX",
"PracticeLocationAddressTelephoneNumber": "011526646849789",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/18/2016",
"LastUpdateDate": "03/18/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARCIA-WILLIAMS",
"AuthorizedOfficialFirstName": "BELISARIO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "011526646849789",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "417014",
"LicenseNumberStateCode": "ZZ",
"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."
}
}
}
}