{
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"OrgName": "V O JOHNSON PROGRESSIVE DENTAL DDS PA",
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"FirstLineMailingAddress": "103 CARLTON DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DUMAS",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "71639-2836",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-382-2777",
"MailingAddressFaxNumber": "870-382-2877",
"FirstLinePracticeLocationAddress": "103 CARLTON DR",
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"PracticeLocationAddressFaxNumber": "870-382-2877",
"EnumerationDate": "04/05/2016",
"LastUpdateDate": "12/20/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "JOHNSON",
"AuthorizedOfficialFirstName": "VEDNA",
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"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.D.S.",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "2642",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}