{
"Npi": {
"NPI": "1619251014",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TOM J MILLER DDS PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "150 S BLOOMINGDALE RD",
"SecondLineMailingAddress": "#200",
"MailingAddressCityName": "BLOOMINGDALE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60108-1493",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-980-4988",
"MailingAddressFaxNumber": "630-980-1375",
"FirstLinePracticeLocationAddress": "231 S GARY AVE",
"SecondLinePracticeLocationAddress": "#107",
"PracticeLocationAddressCityName": "BLOOMINGDALE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60108-2234",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-980-4988",
"PracticeLocationAddressFaxNumber": "630-980-1375",
"EnumerationDate": "10/04/2011",
"LastUpdateDate": "06/25/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MILLER",
"AuthorizedOfficialFirstName": "TOM",
"AuthorizedOfficialMiddleName": "JOSEPH",
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "630-980-4988",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "019019146",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}