{
"Npi": {
"NPI": "1932371697",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JOHN L. PHILLIPS, 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": "405 SHAWCROFT RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FAYETTEVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28311-2946",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "910-822-8221",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "201 S MCPHERSON CHURCH RD STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FAYETTEVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28303-4913",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-438-9400",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/01/2008",
"LastUpdateDate": "04/01/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHILLIPS",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "LLOYD",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "910-822-8221",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "6772",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}