{
"Npi": {
"NPI": "1902795750",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "DUBOIS",
"FirstName": "KRISTINA",
"MiddleName": "M",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "407 RACE ST APT 1207",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CINCINNATI",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45202-3768",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "774-287-3724",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7701 VOICE OF AMERICA CENTRE DR STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEST CHESTER",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "45069-2792",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "513-653-2847",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/28/2025",
"LastUpdateDate": "06/28/2025",
"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": "30.028111",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}