{
"Npi": {
"NPI": "1760542757",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LANCE TIMMERMAN DMD PS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7100 FORT DENT WAY",
"SecondLineMailingAddress": "SUITE 270",
"MailingAddressCityName": "TUKWILA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98188-7500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-241-5533",
"MailingAddressFaxNumber": "206-241-5538",
"FirstLinePracticeLocationAddress": "7100 FORT DENT WAY",
"SecondLinePracticeLocationAddress": "SUITE 270",
"PracticeLocationAddressCityName": "TUKWILA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98188-7500",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-241-5533",
"PracticeLocationAddressFaxNumber": "206-241-5538",
"EnumerationDate": "12/11/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TIMMERMAN",
"AuthorizedOfficialFirstName": "LANCE",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "206-241-5533",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "8229",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}