{"npi":"1356634471","type":"NPI-2","status":"active","name":{"display":"Southern Indiana Pediatric Dentistry, LLC","other":[],"organization_name":"SOUTHERN INDIANA PEDIATRIC DENTISTRY, LLC","authorised_official":"Matthew Rasche"},"specialty":{"primary_taxonomy":"1223P0221X","primary_taxonomy_description":"Pediatric Dentistry","slug":"pediatric-dentistry","schema_org_specialty":null,"all":[{"code":"1223P0221X","description":"Pediatric Dentistry","primary":true,"state":"IN","license":"12011284A"}]},"addresses":[{"purpose":"LOCATION","street_1":"828 S AUTO MALL RD","city":"BLOOMINGTON","state":"IN","postal_code":"474015430","country_code":"US","phone":"8123335437","fax":"8123336305"},{"purpose":"MAILING","street_1":"828 S AUTO MALL RD","city":"BLOOMINGTON","state":"IN","postal_code":"474015430","country_code":"US","phone":"8123335437","fax":"8123336305"}],"license":{"state":"IN","number":"12011284A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"201019080","state":"IN","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2011-05-23","last_updated":"2011-11-22","_meta":{"source":"NPPES","snapshot_date":"2011-11-22","doc_url":"https://findmynpi.com/api"}}