{
"Npi": {
"NPI": "1508152356",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FAMILY DENTAL CARE OF GAINESVILLE, PLLC",
"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": "117 CRYSTAL BROOKE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAPEVINE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76051-8238",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "940-665-4211",
"MailingAddressFaxNumber": "940-665-9581",
"FirstLinePracticeLocationAddress": "112 N DENTON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GAINESVILLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76240-4158",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "940-665-4211",
"PracticeLocationAddressFaxNumber": "940-665-9581",
"EnumerationDate": "06/21/2011",
"LastUpdateDate": "06/21/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAYNE",
"AuthorizedOfficialFirstName": "MATTHEW",
"AuthorizedOfficialMiddleName": "ANTHONY",
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "210-781-9680",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "24498",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}