{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "SMART DENTAL CARE, LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "6234 RIVERINE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BATON ROUGE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70820-5058",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "225-405-5066",
"MailingAddressFaxNumber": "225-677-9993",
"FirstLinePracticeLocationAddress": "34659 LA HIGHWAY 16",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DENHAM SPRINGS",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70706-0667",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "225-405-5066",
"PracticeLocationAddressFaxNumber": "225-677-9993",
"EnumerationDate": "08/22/2016",
"LastUpdateDate": "01/18/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
"AuthorizedOfficialFirstName": "JEREMY",
"AuthorizedOfficialMiddleName": "EMMETT",
"AuthorizedOfficialTitle": "OWNER/DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "225-405-5066",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "5491",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}