{
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"NPI": "1962690586",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "WARREN R. RENSNER, D.D.S., PA.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "404 S EDGEMOOR ST",
"SecondLineMailingAddress": "#320",
"MailingAddressCityName": "WICHITA",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67218-1631",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "316-683-6732",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "404 S EDGEMOOR ST",
"SecondLinePracticeLocationAddress": "#320",
"PracticeLocationAddressCityName": "WICHITA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67218-1631",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "316-683-6732",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/09/2007",
"LastUpdateDate": "10/09/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RENSNER",
"AuthorizedOfficialFirstName": "WARREN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "316-683-6732",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "5851",
"LicenseNumberStateCode": "KS",
"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."
}
}
}
}