{
"Npi": {
"NPI": "1679917058",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENTAL HEALTH AND WELLNESS LLC",
"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": "2433 MORGANTOWN RD",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "READING",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19607-9692",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "610-796-2835",
"MailingAddressFaxNumber": "610-898-1302",
"FirstLinePracticeLocationAddress": "2433 MORGANTOWN RD",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "READING",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19607-9692",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "610-796-2835",
"PracticeLocationAddressFaxNumber": "610-898-1302",
"EnumerationDate": "04/29/2013",
"LastUpdateDate": "07/31/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BALATGEK",
"AuthorizedOfficialFirstName": "TAMMY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DOCTOR/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS, MS",
"AuthorizedOfficialTelephoneNumber": "610-796-2835",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DS030258L",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}