{
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"OrgName": "HETAL PATEL DDS PC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "5568 BECKLEY RD",
"SecondLineMailingAddress": "SUITE 6",
"MailingAddressCityName": "BATTLE CREEK",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49015-4199",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "269-979-9248",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5568 BECKLEY RD",
"SecondLinePracticeLocationAddress": "SUITE 6",
"PracticeLocationAddressCityName": "BATTLE CREEK",
"PracticeLocationAddressStateName": "MI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "269-979-9248",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/26/2016",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATEL",
"AuthorizedOfficialFirstName": "HETAL",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S",
"AuthorizedOfficialTelephoneNumber": "269-979-9248",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "22901020257",
"LicenseNumberStateCode": "MI",
"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."
}
}
}
}