{"npi":"1790403137","type":"NPI-1","status":"active","name":{"display":"Baly Seo Park","other":[],"first":"BALY","last":"SEO PARK","middle":"JUAN"},"specialty":{"primary_taxonomy":"390200000X","primary_taxonomy_description":"Student in an Organized Health Care Education/Training Program","slug":"student-in-an-organized-health-care-education-training-program","schema_org_specialty":null,"all":[{"code":"390200000X","description":"Student in an Organized Health Care Education/Training Program","primary":true,"state":"CT","license":"13568"}]},"addresses":[{"purpose":"LOCATION","street_1":"263 FARMINGTON AVE","city":"FARMINGTON","state":"CT","postal_code":"060300001","country_code":"US","phone":"6798602000"},{"purpose":"MAILING","street_1":"10 TALCOTT RIDGE RD UNIT G","city":"FARMINGTON","state":"CT","postal_code":"060323513","country_code":"US","phone":"9592250288"}],"license":{"state":"CT","number":"13568"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20220929001119","type_code":"33-C5","type_desc":"ORDER AND REFERRING ONLY - DENTIST","state":"CT","pac_id":"4880070747"}]},"enumeration_date":"2022-08-22","last_updated":"2022-09-06","_meta":{"source":"NPPES","snapshot_date":"2022-09-06","doc_url":"https://findmynpi.com/api"}}