{
"Npi": {
"NPI": "1902220320",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRUCE WATERMAN DMD, SLEEP EZ,PL",
"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": "127 KINGSWAY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRANDON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33510-4601",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-689-8462",
"MailingAddressFaxNumber": "813-684-5665",
"FirstLinePracticeLocationAddress": "127 KINGSWAY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRANDON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33510-4601",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "813-689-8462",
"PracticeLocationAddressFaxNumber": "813-684-5665",
"EnumerationDate": "02/05/2014",
"LastUpdateDate": "06/27/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WATERMAN",
"AuthorizedOfficialFirstName": "BRUCE",
"AuthorizedOfficialMiddleName": "DONALD",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "813-689-8462",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DN9391",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}