{
"Npi": {
"NPI": "1730853771",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAMANTHA THOMAS DDS LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1306 N VANSANT RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLINTON",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64735-9303",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "417-438-5924",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "906 E OHIO ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLINTON",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64735-2306",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "417-438-5924",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/03/2021",
"LastUpdateDate": "03/23/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAHONEY",
"AuthorizedOfficialFirstName": "SAMANTHA",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "DENTIST",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "417-438-5924",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}