{
"Npi": {
"NPI": "1689978785",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THOMAS GOTSIS DDS PC",
"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": "12266 DE PAUL DR",
"SecondLineMailingAddress": "#325",
"MailingAddressCityName": "BRIDGETON",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63044-2514",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-291-9000",
"MailingAddressFaxNumber": "314-291-0590",
"FirstLinePracticeLocationAddress": "12266 DE PAUL DR",
"SecondLinePracticeLocationAddress": "#325",
"PracticeLocationAddressCityName": "BRIDGETON",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63044-2514",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "314-291-9000",
"PracticeLocationAddressFaxNumber": "314-291-0590",
"EnumerationDate": "01/04/2011",
"LastUpdateDate": "02/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GOTSIS",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "314-291-9000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BC3200X",
"TaxonomyName": "Customized Equipment (DME)",
"LicenseNumber": "DE0154076",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}