{
"Npi": {
"NPI": "1568855682",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOLDEN KEY DENTAL ,LLC",
"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": "11910 MARY CATHERINE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLINTON",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20735",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "240-997-5007",
"MailingAddressFaxNumber": "800-605-0459",
"FirstLinePracticeLocationAddress": "11910 MARY CATHERINE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLINTON",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20735-1018",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "240-997-5007",
"PracticeLocationAddressFaxNumber": "800-605-0459",
"EnumerationDate": "03/13/2015",
"LastUpdateDate": "03/13/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SKERRITT-RYAN",
"AuthorizedOfficialFirstName": "JERON",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "240-997-5007",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "12037",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}