{
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"FirstLineMailingAddress": "752 SIGMUND RD",
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"MailingAddressTelephoneNumber": "929-340-9390",
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"FirstLinePracticeLocationAddress": "109 N MILWAUKEE AVE FL 2",
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"PracticeLocationAddressCityName": "WHEELING",
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"EnumerationDate": "09/19/2024",
"LastUpdateDate": "09/19/2024",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KO",
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"Taxonomies": {
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"TaxonomyName": "Dental Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}