{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "ROLAND G. VANTRAMP, D.M.D.,P.S.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "600 39TH AVE SW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PUYALLUP",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98373-5900",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "253-770-2777",
"MailingAddressFaxNumber": "253-770-2783",
"FirstLinePracticeLocationAddress": "600 39TH AVE SW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PUYALLUP",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98373-5900",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "253-770-2777",
"PracticeLocationAddressFaxNumber": "253-770-2783",
"EnumerationDate": "03/20/2007",
"LastUpdateDate": "10/30/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VANTRAMP",
"AuthorizedOfficialFirstName": "ROLAND",
"AuthorizedOfficialMiddleName": "GERARD",
"AuthorizedOfficialTitle": "OWNER GENERAL DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "253-770-2777",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "6027",
"LicenseNumberStateCode": "OK",
"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."
}
}
}
}