{
"Npi": {
"NPI": "1477884468",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENNIS E. MINOTTI,II,D.O.,PLLC",
"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": "230 MIRON DRIVE",
"SecondLineMailingAddress": "SUITE 110",
"MailingAddressCityName": "SOUTHLAKE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76092",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-416-0970",
"MailingAddressFaxNumber": "817-898-0898",
"FirstLinePracticeLocationAddress": "230 MIRON DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "SOUTHLAKE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76092",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-416-0970",
"PracticeLocationAddressFaxNumber": "817-898-0898",
"EnumerationDate": "01/15/2010",
"LastUpdateDate": "03/12/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MINOTTI",
"AuthorizedOfficialFirstName": "DENNIS",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "PHYSICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "II",
"AuthorizedOfficialCredential": "D.O",
"AuthorizedOfficialTelephoneNumber": "817-882-9848",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "M5840",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}