{
"Npi": {
"NPI": "1902206725",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHRISTOPHER JOUBERT DDS PC",
"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": "250 PATCHOGUE YAPHANK RD",
"SecondLineMailingAddress": "SUITE 9",
"MailingAddressCityName": "EAST PATCHOGUE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11772-4800",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "631-475-3400",
"MailingAddressFaxNumber": "631-475-3465",
"FirstLinePracticeLocationAddress": "250 PATCHOGUE YAPHANK RD",
"SecondLinePracticeLocationAddress": "SUITE 9",
"PracticeLocationAddressCityName": "EAST PATCHOGUE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11772-4800",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "631-475-3400",
"PracticeLocationAddressFaxNumber": "631-475-3465",
"EnumerationDate": "08/28/2014",
"LastUpdateDate": "08/28/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOUBERT",
"AuthorizedOfficialFirstName": "CHRISTOPHER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "631-404-5261",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "055176-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}