{
"Npi": {
"NPI": "1780881961",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TIMOTHY S MARTINEZ, PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 700",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH WELLFLEET",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02663-0700",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "508-349-6300",
"MailingAddressFaxNumber": "508-349-6385",
"FirstLinePracticeLocationAddress": "CANNON HILL RD AT RTE. 6",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTH WELLFLEET",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02663",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "508-349-6300",
"PracticeLocationAddressFaxNumber": "508-349-6385",
"EnumerationDate": "06/29/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTINEZ",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": "STEVEN",
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "508-349-6300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "16633",
"LicenseNumberStateCode": "MA",
"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."
}
}
}
}