{
"Npi": {
"NPI": "1124957295",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UN DMD, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15010 MONTEZUMA QUAIL DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CYPRESS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77433-7866",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "503-432-0409",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7355 FM 359 RD. S.",
"SecondLinePracticeLocationAddress": "SUITE A-2",
"PracticeLocationAddressCityName": "FULSHEAR",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77441",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-429-2289",
"PracticeLocationAddressFaxNumber": "832-429-2287",
"EnumerationDate": "05/15/2026",
"LastUpdateDate": "05/15/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGUYEN",
"AuthorizedOfficialFirstName": "UAN",
"AuthorizedOfficialMiddleName": "CONG",
"AuthorizedOfficialTitle": "OWNER/GENERAL DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "503-432-0409",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}