{
"Npi": {
"NPI": "1871994426",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DHAM",
"FirstName": "ADITI KIRPAL",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DHAM",
"OtherFirstName": "ADITI KIRPAL",
"OtherMiddleName": null,
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "DMD",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "13203 FRANKLIN VIEW CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FAIRFAX",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22033-1129",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "240-342-0421",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13203 FRANKLIN VIEW CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAIRFAX",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22033-1129",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "240-342-0421",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/12/2014",
"LastUpdateDate": "06/28/2020",
"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": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "0401415406",
"LicenseNumberStateCode": "VA",
"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."
}
}
}
}