{
"Npi": {
"NPI": "1437436441",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WILLIAMS MOBILE DENTAL HYGIENE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6975 HOLT DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLORADO SPRINGS",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80922-1608",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "719-648-9102",
"MailingAddressFaxNumber": "719-358-6009",
"FirstLinePracticeLocationAddress": "6975 HOLT DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLORADO SPRINGS",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "80922-1608",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "719-648-9102",
"PracticeLocationAddressFaxNumber": "719-358-6009",
"EnumerationDate": "11/04/2011",
"LastUpdateDate": "11/04/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLIAMS",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": "LYNETTE",
"AuthorizedOfficialTitle": "OWNER/OPERATOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RDH",
"AuthorizedOfficialTelephoneNumber": "719-648-9102",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DH-905614",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}