{
"Npi": {
"NPI": "1851879738",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GREWAL",
"FirstName": "NAVNEET",
"MiddleName": "KAUR",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "SIDHU (MAIDEN NAME)",
"OtherFirstName": "NAVNEET",
"OtherMiddleName": "KAUR",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3450 RUEMMELE RD APT 313",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND FORKS",
"MailingAddressStateName": "ND",
"MailingAddressPostalCode": "58201-6084",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "612-479-9530",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3300 32ND AVE S STE 103",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND FORKS",
"PracticeLocationAddressStateName": "ND",
"PracticeLocationAddressPostalCode": "58201-5803",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "701-765-3494",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/01/2018",
"LastUpdateDate": "08/01/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "2335",
"LicenseNumberStateCode": "ND",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}