{
"Npi": {
"NPI": "1639252471",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HILLER",
"FirstName": "JOSHUA",
"MiddleName": "MICHAEL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "D.D.S.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "HILLER",
"OtherFirstName": "JOSHUA",
"OtherMiddleName": "MICHAEL",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "D.D.S.",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "223 NW 153RD ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VANCOUVER",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98685-1796",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-648-8551",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "14313 NE 20TH AVE",
"SecondLinePracticeLocationAddress": "SUITE A101",
"PracticeLocationAddressCityName": "VANCOUVER",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98686-1487",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-574-3985",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/23/2006",
"LastUpdateDate": "07/05/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "D12241",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "DE60148458",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}