{"npi":"1972679504","type":"NPI-2","status":"active","name":{"display":"Dwight J Monsma DDS PC","other":[],"organization_name":"DWIGHT J MONSMA DDS PC","authorised_official":"Ewa Ostrowski"},"specialty":{"primary_taxonomy":"122300000X","primary_taxonomy_description":"Dentist","slug":"dentist","schema_org_specialty":null,"all":[{"code":"122300000X","description":"Dentist","primary":true,"state":"MI","license":"2901008106"}]},"addresses":[{"purpose":"LOCATION","street_1":"3521 LAKE EASTBROOK BLVD SE","city":"GRAND RAPIDS","state":"MI","postal_code":"49546","country_code":"US","phone":"6169429891","fax":"6169429891"},{"purpose":"MAILING","street_1":"3521 LAKE EASTBROOK BLVD SE","city":"GRAND RAPIDS","state":"MI","postal_code":"49546","country_code":"US","phone":"6169429891","fax":"6169429894"}],"license":{"state":"MI","number":"2901008106"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"4063994","state":"MI","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-11-27","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}