{
"Npi": {
"NPI": "1932290186",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROBERT SHEKITKA DMD,P.A.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3585 US HIGHWAY 9",
"SecondLineMailingAddress": "SUITE 57",
"MailingAddressCityName": "FREEHOLD",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "07728",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-780-7222",
"MailingAddressFaxNumber": "732-409-7375",
"FirstLinePracticeLocationAddress": "3585 US HIGHWAY 9",
"SecondLinePracticeLocationAddress": "SUITE 57",
"PracticeLocationAddressCityName": "FREEHOLD",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07728-2672",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "732-780-7222",
"PracticeLocationAddressFaxNumber": "732-409-7375",
"EnumerationDate": "09/27/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHEKITKA",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "732-780-7222",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "11332",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}