{
"Npi": {
"NPI": "1609352905",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHAPIRO FAMILY DENTISTRY OF FORT PIERCE PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2247 PALM BEACH LAKES BLVD STE 105",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST PALM BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33409-3408",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-254-2868",
"MailingAddressFaxNumber": "561-328-6217",
"FirstLinePracticeLocationAddress": "CORAL SQUARE SHOPPES 3006 US HIGHWAY 1",
"SecondLinePracticeLocationAddress": "SUITE D2/D3",
"PracticeLocationAddressCityName": "FORT PIERCE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34982",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-242-0053",
"PracticeLocationAddressFaxNumber": "772-242-0081",
"EnumerationDate": "07/19/2018",
"LastUpdateDate": "07/19/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHAPIRO",
"AuthorizedOfficialFirstName": "DARI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "561-254-2868",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}