{
"Npi": {
"NPI": "1841377298",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIFE FAMILY DENTAL",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "403 US HIGHWAY 202",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FLEMINGTON",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08822-6037",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "908-782-4443",
"MailingAddressFaxNumber": "908-782-4443",
"FirstLinePracticeLocationAddress": "403 US HIGHWAY 202",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FLEMINGTON",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08822-6037",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "908-782-4443",
"PracticeLocationAddressFaxNumber": "908-782-4443",
"EnumerationDate": "11/01/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEYFERMAN",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "908-782-4443",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DI21481",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}