{
"Npi": {
"NPI": "1679803738",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SMILE HELP DENTAL",
"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": "PO BOX 10007",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT SMITH",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "72917-0007",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "479-452-2994",
"MailingAddressFaxNumber": "479-484-5865",
"FirstLinePracticeLocationAddress": "1501 S WALDRON RD",
"SecondLinePracticeLocationAddress": "SUITE 208",
"PracticeLocationAddressCityName": "FORT SMITH",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "72903-2574",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "479-452-2994",
"PracticeLocationAddressFaxNumber": "479-484-5865",
"EnumerationDate": "01/12/2010",
"LastUpdateDate": "04/09/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHILLIPS",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "P.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "479-452-2994",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "2034",
"LicenseNumberStateCode": "AR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}