{
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"OrgName": "HAERR DENTISTRY P.C.",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "PO BOX 609",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAYDEN",
"MailingAddressStateName": "CO",
"MailingAddressPostalCode": "81639-0609",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "970-276-3123",
"MailingAddressFaxNumber": "970-276-2500",
"FirstLinePracticeLocationAddress": "150 WEST JACKSON ST",
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"PracticeLocationAddressCityName": "HAYDEN",
"PracticeLocationAddressStateName": "CO",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": "970-276-2500",
"EnumerationDate": "04/11/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAERR",
"AuthorizedOfficialFirstName": "NATHAN",
"AuthorizedOfficialMiddleName": "ADAM",
"AuthorizedOfficialTitle": "OWNER DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "970-276-3123",
"Taxonomies": {
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{
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
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"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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{
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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."
},
{
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
]
}
}
}