{
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "WILLIAM W. MISISCHIA D.D.S. LTD. JOSEPH W. NOETZEL D.D.S. LTD.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "20200 ASHLAND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO HEIGHTS",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60411-1671",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-755-1333",
"MailingAddressFaxNumber": "708-755-2751",
"FirstLinePracticeLocationAddress": "20200 ASHLAND AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHICAGO HEIGHTS",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60411-1671",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-755-1333",
"PracticeLocationAddressFaxNumber": "708-755-2751",
"EnumerationDate": "05/03/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NOETZEL",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "WILLIAM",
"AuthorizedOfficialTitle": "DOCTOR OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "708-755-1333",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "19-011965",
"LicenseNumberStateCode": "IL",
"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."
}
}
}
}