{
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"IsOrgSubpart": "N",
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"OrgName": "COLUMBUS FAMILY DENTAL CARE - AARON CARROLL, DDS & KATHERINE CARROLL,",
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"FirstLineMailingAddress": "4102 HAMMERSMITH CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW ALBANY",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43054-8419",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-353-5604",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3314 NOE BIXBY RD",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "COLUMBUS",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43232-6065",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-353-5604",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/05/2014",
"LastUpdateDate": "02/05/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CARROLL",
"AuthorizedOfficialFirstName": "AARON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTIST/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "614-353-5604",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "30.023283",
"LicenseNumberStateCode": "OH",
"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."
}
}
}
}