{"npi":"1154480002","type":"NPI-2","status":"active","name":{"display":"Comprehensive Dental Services Ltd","other":[],"organization_name":"COMPREHENSIVE DENTAL SERVICES LTD","authorised_official":"Marc Jacobson"},"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":true,"state":"WI","license":"2475-015"}]},"addresses":[{"purpose":"LOCATION","street_1":"10521 N PORT WASHINGTON RD","city":"MEQUON","state":"WI","postal_code":"53092","country_code":"US","street_2":"SUITE 200","phone":"2622412060","fax":"2622412064"},{"purpose":"MAILING","street_1":"10521 N PORT WASHINGTON RD","city":"MEQUON","state":"WI","postal_code":"53092","country_code":"US","street_2":"SUITE 200","phone":"2622412060","fax":"2622412064"}],"license":{"state":"WI","number":"2475-015"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"33412900","state":"WI","issuer":null},{"type_code":"05","label":"Medicaid","value":"33378400","state":"WI","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-12-06","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}