{
"Npi": {
"NPI": "1912810557",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LOURIDO PERIODONTICS, LLC",
"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": "GC28 CALLE 418",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAROLINA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00982-1932",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "939-539-0849",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "525 AVE F. D. ROOSEVELT",
"SecondLinePracticeLocationAddress": "SUITE 704 PLAZA LAS AMERICAS TOWER",
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00918",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-767-7967",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/24/2026",
"LastUpdateDate": "09/24/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOURIDO MARTINEZ",
"AuthorizedOfficialFirstName": "GIAN",
"AuthorizedOfficialMiddleName": "DANIEL",
"AuthorizedOfficialTitle": "PRESIDENT - PERIODONTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD, MSD",
"AuthorizedOfficialTelephoneNumber": "939-539-0849",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}