{
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"NamePrefix": null,
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"FirstLineMailingAddress": "250 W BRIDGE ST",
"SecondLineMailingAddress": "102",
"MailingAddressCityName": "DUBLIN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43017-2123",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-889-0777",
"MailingAddressFaxNumber": "614-889-9255",
"FirstLinePracticeLocationAddress": "250 W BRIDGE ST",
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"PracticeLocationAddressStateName": "OH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-889-0777",
"PracticeLocationAddressFaxNumber": "614-889-9255",
"EnumerationDate": "03/22/2011",
"LastUpdateDate": "08/07/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HINKLE",
"AuthorizedOfficialFirstName": "ROBERT",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223S0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "18713",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
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}
}
}
}