{
"Npi": {
"NPI": "1447549837",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ERIC E. MARTIN, DDS, PC",
"ParentOrgTIN": null,
"OrgName": "KDB, LLC",
"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": "3688 CAMPUS DR STE 220",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EAGLE MOUNTAIN",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84005-4669",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3688 CAMPUS DR STE 220",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAGLE MOUNTAIN",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84005-4669",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-341-7999",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/06/2011",
"LastUpdateDate": "04/06/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTIN",
"AuthorizedOfficialFirstName": "ERIC",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/PEDIATRIC DENTIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "801-676-8899",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "49554449923",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}