NPI Code Detail JSON Logo

1699940338 NPI number — TOOTHFAIRYDENTALSPA,LLC

NPI Number: 1699940338
Health Care Provider/Practitioner: TOOTHFAIRYDENTALSPA,LLC

Information about “1699940338” NPI (TOOTHFAIRYDENTALSPA,LLC) exists in 1699940338 in HTML format HTML  |  1699940338 in plain Text format TXT  |  1699940338 in PDF (Portable Document Format) PDF  |  1699940338 in an XML format XML  formats.

NPI Number : 1699940338 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699940338",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "TOOTHFAIRYDENTALSPA,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": "503 PLAINSBORO RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PLAINSBORO",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08536-2003",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "609-452-2600",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "503 PLAINSBORO RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PLAINSBORO",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08536-2003",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "609-452-2600",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/24/2008",
    "LastUpdateDate": "04/24/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HABIBIAN",
    "AuthorizedOfficialFirstName": "MARJAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "609-452-2600",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "17012",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223P0300X",
          "TaxonomyName": "Periodontics",
          "LicenseNumber": "22DI01847104",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223X0400X",
          "TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
          "LicenseNumber": "22DI02022700",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "17015",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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