{
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"FirstLineMailingAddress": "20106 PIONEER BLVD STE A&B",
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"MailingAddressCityName": "CERRITOS",
"MailingAddressStateName": "CA",
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"FirstLinePracticeLocationAddress": "20106 S BLVD STE A & B",
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"PracticeLocationAddressCityName": "CERRITOS",
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"EnumerationDate": "09/05/2019",
"LastUpdateDate": "10/22/2019",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "MELENDREZ",
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"AuthorizedOfficialTelephoneNumber": "626-330-6655",
"Taxonomies": {
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"TaxonomyName": "Dental Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}