{
"Npi": {
"NPI": "1417484163",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "STOBBE EGGETT DENTAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "625 E 500 S",
"SecondLineMailingAddress": "SUITE 201",
"MailingAddressCityName": "BOUNTIFUL",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84010-3882",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-292-0443",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "625 E 500 S",
"SecondLinePracticeLocationAddress": "SUITE 201",
"PracticeLocationAddressCityName": "BOUNTIFUL",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84010-3882",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-292-0443",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/12/2017",
"LastUpdateDate": "05/12/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HENRY",
"AuthorizedOfficialFirstName": "SUZIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "801-292-0443",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "4923271",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}