{
"Npi": {
"NPI": "1912500364",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RONNIE L FAULKNER, 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": "PO BOX 901",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNT IDA",
"MailingAddressStateName": "AR",
"MailingAddressPostalCode": "71957-0901",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "870-867-3432",
"MailingAddressFaxNumber": "870-867-3783",
"FirstLinePracticeLocationAddress": "138 HIGHWAY 270 E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MOUNT IDA",
"PracticeLocationAddressStateName": "AR",
"PracticeLocationAddressPostalCode": "71957-9409",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-867-3432",
"PracticeLocationAddressFaxNumber": "870-867-3783",
"EnumerationDate": "11/18/2020",
"LastUpdateDate": "11/18/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FAULKNER",
"AuthorizedOfficialFirstName": "RONNIE",
"AuthorizedOfficialMiddleName": "LEE",
"AuthorizedOfficialTitle": "PRESIDE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "501-276-3432",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}