{
"Npi": {
"NPI": "1710258397",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENNIS MICHAEL SULLIVAN, D.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2305 SE WASHINGTON ST STE 109",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILWAUKIE",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97222-7647",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-709-8946",
"MailingAddressFaxNumber": "503-659-4445",
"FirstLinePracticeLocationAddress": "2305 SE WASHINGTON ST STE 109",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MILWAUKIE",
"PracticeLocationAddressStateName": "OR",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "503-709-8946",
"PracticeLocationAddressFaxNumber": "503-659-4445",
"EnumerationDate": "01/13/2012",
"LastUpdateDate": "01/13/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SULLIVAN",
"AuthorizedOfficialFirstName": "DENNIS",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "503-709-8946",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "27-2247",
"LicenseNumberStateCode": "OR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}