{
"Npi": {
"NPI": "1669877270",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CAPITAL DENTAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4918 TURQUOISE AVE SE",
"SecondLineMailingAddress": "APT D-304",
"MailingAddressCityName": "SALEM",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97317-4104",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "971-388-7725",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "408 LANCASTER DR NE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SALEM",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97301-4728",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-362-3032",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/24/2014",
"LastUpdateDate": "10/24/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CASTANO",
"AuthorizedOfficialFirstName": "RODRIGO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTURIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LD",
"AuthorizedOfficialTelephoneNumber": "971-388-7725",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "10150616",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}