{
"Npi": {
"NPI": "1740672393",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WILLIAM A LOVELL, III, DMD",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1900 28TH AVE S",
"SecondLineMailingAddress": "SUITE 109",
"MailingAddressCityName": "HOMEWOOD",
"MailingAddressStateName": "AL",
"MailingAddressPostalCode": "35209-2687",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "205-957-6611",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1900 28TH AVE S",
"SecondLinePracticeLocationAddress": "SUITE 109",
"PracticeLocationAddressCityName": "HOMEWOOD",
"PracticeLocationAddressStateName": "AL",
"PracticeLocationAddressPostalCode": "35209-2687",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "205-957-6611",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/19/2015",
"LastUpdateDate": "02/19/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOVELL",
"AuthorizedOfficialFirstName": "WILLIAM",
"AuthorizedOfficialMiddleName": "ADRIAN",
"AuthorizedOfficialTitle": "DENTIST/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": "D.M.D",
"AuthorizedOfficialTelephoneNumber": "352-318-2601",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223P0221X",
"TaxonomyName": "Pediatric Dentistry",
"LicenseNumber": "5816",
"LicenseNumberStateCode": "AL",
"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."
}
}
}
}