{
"Npi": {
"NPI": "1477299253",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KEVIN GRILL DDS, 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": "6446 NEWGRANGE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DUBLIN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43016-8210",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-827-5184",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7421 STATE ROUTE 366",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUNTSVILLE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43324-9670",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "937-843-3932",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/05/2022",
"LastUpdateDate": "01/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRILL",
"AuthorizedOfficialFirstName": "KEVIN",
"AuthorizedOfficialMiddleName": "BRENNAN",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "614-827-5184",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}