{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JOAN HOVERMAN, DDS",
"LastName": null,
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"NamePrefix": null,
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"OtherOrgName": null,
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"FirstLineMailingAddress": "4100 W MAPLE ST",
"SecondLineMailingAddress": "C/O FAMILY DENTISTRY & PREVENTIVE CARE",
"MailingAddressCityName": "WICHITA",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "67209-2538",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "316-530-3191",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4100 W MAPLE ST",
"SecondLinePracticeLocationAddress": "C/O FAMILY DENTISTRY & PREVENTIVE CARE BUILDING",
"PracticeLocationAddressCityName": "WICHITA",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "67209-2538",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "316-530-3191",
"PracticeLocationAddressFaxNumber": "316-854-0821",
"EnumerationDate": "01/28/2014",
"LastUpdateDate": "01/28/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOVERMAN",
"AuthorizedOfficialFirstName": "JOAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER / OPERATOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "316-530-3191",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "60251",
"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."
}
}
}
}