{
"Npi": {
"NPI": "1447701420",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREGORY K. RABITZ, D.D.S., A PROFESSIONAL CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15466 LOS GATOS BLVD",
"SecondLineMailingAddress": "#109218",
"MailingAddressCityName": "LOS GATOS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95032-2542",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "408-309-4323",
"MailingAddressFaxNumber": "408-827-4059",
"FirstLinePracticeLocationAddress": "1600 WILLOW ST",
"SecondLinePracticeLocationAddress": "STE 250",
"PracticeLocationAddressCityName": "SAN JOSE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95125-5115",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "408-309-4323",
"PracticeLocationAddressFaxNumber": "408-827-4059",
"EnumerationDate": "10/14/2016",
"LastUpdateDate": "10/14/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RABITZ",
"AuthorizedOfficialFirstName": "GREGORY",
"AuthorizedOfficialMiddleName": "KIRK",
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "408-309-4323",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "47781",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}