{
"Npi": {
"NPI": "1760656771",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "S. P, MCINTOSH, DDS, PLLC",
"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": "PO BOX 899",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EUFAULA",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74432-0899",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-689-2583",
"MailingAddressFaxNumber": "918-689-1838",
"FirstLinePracticeLocationAddress": "900 BIRKES RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EUFAULA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74432-4023",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-689-2583",
"PracticeLocationAddressFaxNumber": "918-689-1838",
"EnumerationDate": "04/22/2008",
"LastUpdateDate": "04/22/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCINTOSH",
"AuthorizedOfficialFirstName": "STANLEY",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "918-689-2583",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "03772",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}