{
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"FirstLineMailingAddress": "6915 ANTOINE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77091-1214",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-741-7400",
"MailingAddressFaxNumber": "281-741-7400",
"FirstLinePracticeLocationAddress": "6915 ANTOINE DR",
"SecondLinePracticeLocationAddress": "SUITE 100",
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"PracticeLocationAddressFaxNumber": "281-741-7406",
"EnumerationDate": "09/06/2016",
"LastUpdateDate": "10/01/2025",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TATARI",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "832-288-4090",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Dentistry",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}