{
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"FirstLineMailingAddress": "13821 N. 35TH DRIVE SUITE 2",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-375-8063",
"MailingAddressFaxNumber": "602-863-3412",
"FirstLinePracticeLocationAddress": "13821 N 35TH DR STE 2",
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"PracticeLocationAddressTelephoneNumber": "602-375-8063",
"PracticeLocationAddressFaxNumber": "602-863-3412",
"EnumerationDate": "06/23/2010",
"LastUpdateDate": "06/23/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CORE",
"AuthorizedOfficialFirstName": "GARY",
"AuthorizedOfficialMiddleName": "JOSEPH",
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"AuthorizedOfficialCredential": "D.D.S",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dentist",
"LicenseNumber": "2928",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}