{
"Npi": {
"NPI": "1932182755",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "IOMMAZZO",
"FirstName": "SILVESTRO",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": "JR.",
"Credential": "D.D.S",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "127 KINGS HWY N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESTPORT",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06880-2422",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "203-227-2377",
"MailingAddressFaxNumber": "203-227-1682",
"FirstLinePracticeLocationAddress": "176 -60 UNION TURNPIKE",
"SecondLinePracticeLocationAddress": "SUITE 120",
"PracticeLocationAddressCityName": "FLUSHING",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11366",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-969-1700",
"PracticeLocationAddressFaxNumber": "718-969-1058",
"EnumerationDate": "11/25/2005",
"LastUpdateDate": "05/09/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223P0221X",
"TaxonomyName": "Pediatric Dentistry",
"LicenseNumber": "044312",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}