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1780346361 NPI number — COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA

NPI Number: 1780346361
Health Care Provider/Practitioner: COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA

Information about “1780346361” NPI (COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA) exists in 1780346361 in HTML format HTML  |  1780346361 in plain Text format TXT  |  1780346361 in PDF (Portable Document Format) PDF  |  1780346361 in an XML format XML  formats.

NPI Number : 1780346361 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780346361",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA",
    "ParentOrgTIN": null,
    "OrgName": "COMFORTABLE CARE DENTA HEALTH PROFESSIONALS, PA",
    "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": "4512 N FLAGLER DR STE 301",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEST PALM BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33407-3897",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4512 N FLAGLER DR STE 301",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WEST PALM BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33407-3897",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "561-421-8395",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/11/2021",
    "LastUpdateDate": "10/11/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "THULL",
    "AuthorizedOfficialFirstName": "HILLARY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CREDENTIALING COORDINATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "217-540-8946",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "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."
      }
    }
  }
}
                
            

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