{
"Npi": {
"NPI": "1518015114",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "L'TANYA J. BAILEY, D.D.S, MS, 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": "PO BOX 6074",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HIGH POINT",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27262-6074",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-886-7000",
"MailingAddressFaxNumber": "336-886-7002",
"FirstLinePracticeLocationAddress": "6425 OLD PLANK RD",
"SecondLinePracticeLocationAddress": "SUITE 108",
"PracticeLocationAddressCityName": "HIGH POINT",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27265-3277",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-886-7000",
"PracticeLocationAddressFaxNumber": "336-886-7002",
"EnumerationDate": "01/08/2007",
"LastUpdateDate": "09/24/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BAILEY",
"AuthorizedOfficialFirstName": "L'TANYA",
"AuthorizedOfficialMiddleName": "JOY",
"AuthorizedOfficialTitle": "ORTHODONTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S., MS, PLLC",
"AuthorizedOfficialTelephoneNumber": "336-886-7000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "5199",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}