{"npi":"1114198108","type":"NPI-2","status":"active","name":{"display":"Fogg/Zareie Enterprises Inc.","other":[],"organization_name":"FOGG/ZAREIE ENTERPRISES INC.","authorised_official":"Robert Fogg"},"specialty":{"primary_taxonomy":"1223G0001X","primary_taxonomy_description":"General Practice Dentistry","slug":"general-practice-dentistry","schema_org_specialty":null,"all":[{"code":"1223G0001X","description":"General Practice Dentistry","primary":false,"state":"GA","license":"009000"},{"code":"1223G0001X","description":"General Practice Dentistry","primary":true,"state":"GA","license":"006805"}]},"addresses":[{"purpose":"LOCATION","street_1":"3380 OLD JEFFERSON RD","city":"ATHENS","state":"GA","postal_code":"306071480","country_code":"US","phone":"7065483279","fax":"7065466475"},{"purpose":"MAILING","street_1":"3380 OLD JEFFERSON RD","city":"ATHENS","state":"GA","postal_code":"306071480","country_code":"US","phone":"7065483279","fax":"7065466475"}],"license":{"state":"GA","number":"006805"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00176778C","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"00862705A","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"00915516A","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"00508065A","state":"GA","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2008-03-18","last_updated":"2008-03-18","_meta":{"source":"NPPES","snapshot_date":"2008-03-18","doc_url":"https://findmynpi.com/api"}}