{
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"FirstLineMailingAddress": "3471 LONG BEACH RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OCEANSIDE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11572-5424",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-536-5800",
"MailingAddressFaxNumber": "516-536-0186",
"FirstLinePracticeLocationAddress": "3471 LONG BEACH RD",
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"PracticeLocationAddressCityName": "OCEANSIDE",
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"PracticeLocationAddressFaxNumber": "516-536-0186",
"EnumerationDate": "01/28/2011",
"LastUpdateDate": "01/28/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHATZ",
"AuthorizedOfficialFirstName": "ADAM",
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"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "516-536-5800",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dentist",
"LicenseNumber": "047087",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}