{
"Npi": {
"NPI": "1902030638",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RAYMOND T. BEDETTE, DDS, PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1 WILLOW RUN",
"SecondLineMailingAddress": "1-A",
"MailingAddressCityName": "AUBURN",
"MailingAddressStateName": "ME",
"MailingAddressPostalCode": "04210-8501",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "207-784-8587",
"MailingAddressFaxNumber": "207-777-5251",
"FirstLinePracticeLocationAddress": "1 WILLOW RUN",
"SecondLinePracticeLocationAddress": "1-A",
"PracticeLocationAddressCityName": "AUBURN",
"PracticeLocationAddressStateName": "ME",
"PracticeLocationAddressPostalCode": "04210-8501",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "207-784-8587",
"PracticeLocationAddressFaxNumber": "207-777-5251",
"EnumerationDate": "05/10/2009",
"LastUpdateDate": "05/10/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEDETTE",
"AuthorizedOfficialFirstName": "RAYMOND",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "PRESIDENT/ORTHODONTIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "207-784-8587",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "2797",
"LicenseNumberStateCode": "ME",
"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."
}
}
}
}