{
"Npi": {
"NPI": "1831252840",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TUCKER",
"FirstName": "JONATHAN",
"MiddleName": "DANIEL",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2504 HILLTOP ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROUND ROCK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78681-1600",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-260-9333",
"MailingAddressFaxNumber": "512-260-9331",
"FirstLinePracticeLocationAddress": "10703 E. CRYSTAL FALLS PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEANDER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78641-2259",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-260-9333",
"PracticeLocationAddressFaxNumber": "512-260-9331",
"EnumerationDate": "12/19/2006",
"LastUpdateDate": "05/13/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "22102",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}