{
"Npi": {
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"EIN": null,
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"OrgName": "ROBERT R. THEIL D.D.S. AND THOMAS D. THEIL D.D.S., INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5509 BRANDT PIKE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUBER HEIGHTS",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45424-6117",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "937-233-7121",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5509 BRANDT PIKE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUBER HEIGHTS",
"PracticeLocationAddressStateName": "OH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "937-233-7121",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/21/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THEIL",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "937-233-7121",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "31020160",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}