{
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"IsOrgSubpart": "N",
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"OrgName": "KURUVADI DDS INC",
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"FirstLineMailingAddress": "810 JAMACHA RD STE 205",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EL CAJON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92019-3223",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "619-442-4141",
"MailingAddressFaxNumber": "619-442-3199",
"FirstLinePracticeLocationAddress": "810 JAMACHA RD STE 205",
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"PracticeLocationAddressCityName": "EL CAJON",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "619-442-4141",
"PracticeLocationAddressFaxNumber": "619-442-3199",
"EnumerationDate": "08/06/2007",
"LastUpdateDate": "08/06/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KURUVADI",
"AuthorizedOfficialFirstName": "SANJAY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "619-474-1554",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "42674",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}