{
"Npi": {
"NPI": "1801959515",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JEFFREY P ALEXANDER DDS A DENTAL CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 14266",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OAKLAND",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-568-3577",
"MailingAddressFaxNumber": "510-568-8178",
"FirstLinePracticeLocationAddress": "8201 EDGEWATER DR",
"SecondLinePracticeLocationAddress": "SUITE 105 &106",
"PracticeLocationAddressCityName": "OAKLAND",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94621",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-568-3577",
"PracticeLocationAddressFaxNumber": "510-568-8178",
"EnumerationDate": "12/18/2006",
"LastUpdateDate": "11/30/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALEXANDER",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "510-568-3577",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "26327",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}