{
"Npi": {
"NPI": "1952310526",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "THOMAS",
"FirstName": "CLIFFORD",
"MiddleName": "L.",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS., MS.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "14601 DETROIT AVE",
"SecondLineMailingAddress": "#620",
"MailingAddressCityName": "LAKEWOOD",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44107-4214",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "216-221-5595",
"MailingAddressFaxNumber": "216-221-7147",
"FirstLinePracticeLocationAddress": "14601 DETROIT AVE",
"SecondLinePracticeLocationAddress": "#620",
"PracticeLocationAddressCityName": "LAKEWOOD",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44107-4214",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "216-221-5595",
"PracticeLocationAddressFaxNumber": "216-221-7147",
"EnumerationDate": "08/05/2006",
"LastUpdateDate": "07/08/2007",
"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": "1223P0300X",
"TaxonomyName": "Periodontics",
"LicenseNumber": "19720",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}