{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "HEALTHY SMILE PLC",
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"MiddleName": null,
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"FirstLineMailingAddress": "PO BOX 8228",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KENTWOOD",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49518-8228",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "616-281-8338",
"MailingAddressFaxNumber": "616-281-1162",
"FirstLinePracticeLocationAddress": "2021 44TH ST SW",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND RAPIDS",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49508",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "616-281-8338",
"PracticeLocationAddressFaxNumber": "616-281-1162",
"EnumerationDate": "06/30/2015",
"LastUpdateDate": "06/30/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ONA",
"AuthorizedOfficialFirstName": "SUZZETTE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/DENTIST",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "616-281-8338",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "17705",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}