{
"Npi": {
"NPI": "1619220811",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MICHAEL ALLEN CIAVERELLI, DDS, P.A.",
"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": "4029 S CAPITAL OF TEXAS HWY",
"SecondLineMailingAddress": "SUITE 109",
"MailingAddressCityName": "AUSTIN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78704-7927",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-445-5866",
"MailingAddressFaxNumber": "512-445-4262",
"FirstLinePracticeLocationAddress": "4029 S CAPITAL OF TEXAS HWY",
"SecondLinePracticeLocationAddress": "SUITE 109",
"PracticeLocationAddressCityName": "AUSTIN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78704-7927",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-445-5866",
"PracticeLocationAddressFaxNumber": "512-445-4262",
"EnumerationDate": "10/25/2012",
"LastUpdateDate": "10/25/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CIAVERELLI",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "512-445-5866",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}