{
"Npi": {
"NPI": "1831074269",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARK R. POLLE, DDS. PLLC",
"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": "1101 LAWNDALE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CELINA",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75009-1792",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "712-253-9420",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2700 W. FRONTIER PARKWAY STE. 120",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PROSPER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75078",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-216-0843",
"PracticeLocationAddressFaxNumber": "214-278-6603",
"EnumerationDate": "08/06/2025",
"LastUpdateDate": "08/08/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POLLE",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "712-253-9420",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}