{
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"IsOrgSubpart": "N",
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"OrgName": "ALPINE DENTAL SERVICES LINCOLN, PLLC",
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"FirstName": null,
"MiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12501 E LINCOLN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ENGLEWOOD",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "80112-4753",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "303-768-8137",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "12501 E LINCOLN AVE",
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"PracticeLocationAddressCityName": "ENGLEWOOD",
"PracticeLocationAddressStateName": "CO",
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"PracticeLocationAddressTelephoneNumber": "303-768-8137",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/20/2019",
"LastUpdateDate": "11/20/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BECERRA",
"AuthorizedOfficialFirstName": "JUSTIN",
"AuthorizedOfficialMiddleName": "FORD",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "303-980-4800",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}