{
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"OrgName": "VILLAGE DENTAL GROUP",
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"FirstLineMailingAddress": "112 SAUNDERSVILLE RD",
"SecondLineMailingAddress": "SUITE B226",
"MailingAddressCityName": "HENDERSONVILLE",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37075-8913",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-822-2626",
"MailingAddressFaxNumber": "615-822-3626",
"FirstLinePracticeLocationAddress": "112 SAUNDERSVILLE RD",
"SecondLinePracticeLocationAddress": "SUITE B226",
"PracticeLocationAddressCityName": "HENDERSONVILLE",
"PracticeLocationAddressStateName": "TN",
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"PracticeLocationAddressFaxNumber": "615-822-3626",
"EnumerationDate": "11/06/2009",
"LastUpdateDate": "11/06/2009",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FOSTER",
"AuthorizedOfficialFirstName": "SHAWN",
"AuthorizedOfficialMiddleName": "RAE",
"AuthorizedOfficialTitle": "PRACTICE ADMINISTRATOR",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "615-498-4323",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dentist",
"LicenseNumber": "5040",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}