{
"Npi": {
"NPI": "1750881397",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "JEWELL",
"FirstName": "ABBY",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "D.D.S.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "925 NW BENT TREE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEES SUMMIT",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64081-1836",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "816-560-8351",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2070 NW LOWENSTEIN DR STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEES SUMMIT",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64081-1903",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-287-1010",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/20/2018",
"LastUpdateDate": "01/26/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "1223S0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "D14084",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223S0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "----",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "2023005835",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}