{
"Npi": {
"NPI": "1023077377",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AMINI",
"FirstName": "ELHAM",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS PC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "AMIN",
"OtherFirstName": "ELHAM",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "18121 GEORGIA AVENUE",
"SecondLineMailingAddress": "STE 101",
"MailingAddressCityName": "OLNEY",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20832",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-570-2100",
"MailingAddressFaxNumber": "301-570-3502",
"FirstLinePracticeLocationAddress": "18121 GEORGIA AVENUE",
"SecondLinePracticeLocationAddress": "LSTE 101",
"PracticeLocationAddressCityName": "OLNEY",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20832",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-570-2100",
"PracticeLocationAddressFaxNumber": "301-570-3502",
"EnumerationDate": "03/23/2006",
"LastUpdateDate": "05/25/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "0401410525",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "11446",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}