{
"Npi": {
"NPI": "1568625853",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RYAN W. WHITMAN FAMILY & COSMETIC DENTISTRY, 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": "1165 S CAMINO DEL RIO STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DURANGO",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "81303-6824",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "970-382-8111",
"MailingAddressFaxNumber": "970-385-4529",
"FirstLinePracticeLocationAddress": "1165 S CAMINO DEL RIO STE 300",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DURANGO",
"PracticeLocationAddressStateName": "CO",
"PracticeLocationAddressPostalCode": "81303-6824",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "970-382-8111",
"PracticeLocationAddressFaxNumber": "970-385-4529",
"EnumerationDate": "07/07/2008",
"LastUpdateDate": "10/25/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WHITMAN",
"AuthorizedOfficialFirstName": "BROOKE",
"AuthorizedOfficialMiddleName": "TENNILLE",
"AuthorizedOfficialTitle": "BUSINESS MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "918-671-8839",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DEN.00202133",
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}