{
"Npi": {
"NPI": "1992969380",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WYSON",
"FirstName": "JENNIFER",
"MiddleName": "W",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "DMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GREENHALGH",
"OtherFirstName": "JENNIFER",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1512 RENAISSANCE TOWNE DRIVE",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "BOUNTIFUL",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84010",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-292-2622",
"MailingAddressFaxNumber": "801-292-2258",
"FirstLinePracticeLocationAddress": "1512 RENAISSANCE TOWNE DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "BOUNTIFUL",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84010",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-292-2622",
"PracticeLocationAddressFaxNumber": "801-292-2258",
"EnumerationDate": "07/15/2008",
"LastUpdateDate": "08/09/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "6947302-9922",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}