{
  "npi": "1770196024",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2022-04-27",
    "credential": "DDS",
    "enumeration_date": "2020-08-26",
    "first_name": "KEVIN",
    "last_name": "BIBERA",
    "last_updated": "2022-04-27",
    "middle_name": "TAN",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1854 CLAIRE CT",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "CONCORD",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "945192359",
      "state": "CA",
      "telephone_number": "424-325-9270"
    },
    {
      "address_1": "875 UNION AVENUE SUITE C211",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MEMPHIS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "381638781",
      "state": "TN",
      "telephone_number": "901-448-7180"
    }
  ],
  "taxonomies": [
    {
      "code": "1223G0001X",
      "desc": "Dentist, General Practice",
      "license": "105025",
      "primary": false,
      "state": "CA",
      "taxonomy_group": ""
    },
    {
      "code": "390200000X",
      "desc": "Student in an Organized Health Care Education/Training Program",
      "license": "105025",
      "primary": true,
      "state": "CA",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Student in an Organized Health Care Education/Training Program",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}