{
"Npi": {
"NPI": "1831453869",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHATTUCK",
"FirstName": "WILLIAM",
"MiddleName": "DEAN",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.D.S.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "14208 TIJUANA TRL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HASLET",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76052-4894",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-934-9287",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "295 FM 156 S.",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "HASLET",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76052",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-439-8393",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/25/2012",
"LastUpdateDate": "04/01/2016",
"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": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "6430",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "31589",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}