{
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"FirstLineMailingAddress": "1628 MEMORIAL DR STE A",
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"MailingAddressStateName": "NC",
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"FirstLinePracticeLocationAddress": "1628 MEMORIAL DR STE A",
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"PracticeLocationAddressCityName": "BURLINGTON",
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"EnumerationDate": "03/30/2026",
"LastUpdateDate": "03/30/2026",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "KEMP",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}