{
"Npi": {
"NPI": "1871867416",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DEENA SANDALL, OD., LLC",
"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": "1141 N 199TH CIR W",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GODDARD",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67052-8835",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "316-210-0362",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1151 N ROCK RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WICHITA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67206-1262",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "316-268-5000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/29/2012",
"LastUpdateDate": "07/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANDALL",
"AuthorizedOfficialFirstName": "DEENA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "316-210-0362",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152WL0500X",
"TaxonomyName": "Low Vision Rehabilitation Optometrist",
"LicenseNumber": "1723",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}