{
"Npi": {
"NPI": "1578016689",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PEDIATRIC DENTISTRY OF READING P.C.",
"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": "5001 PERKIOMEN AVE",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "READING",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19606-9614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "484-334-2310",
"MailingAddressFaxNumber": "484-334-2311",
"FirstLinePracticeLocationAddress": "5001 PERKIOMEN AVE",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "READING",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19606-9614",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "484-334-2310",
"PracticeLocationAddressFaxNumber": "484-334-2311",
"EnumerationDate": "07/26/2016",
"LastUpdateDate": "07/26/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRATSON",
"AuthorizedOfficialFirstName": "BETHANY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "724-601-6951",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DS038715",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}