{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "RAMTIN KHAEF DMD DENTAL CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"FirstLineMailingAddress": "27758 SANTA MARGARITA PKWY # 382",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MISSION VIEJO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92691-6709",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-445-3555",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9907 WALKER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CYPRESS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90630-3827",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-581-8585",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/04/2019",
"LastUpdateDate": "06/04/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KHAEF",
"AuthorizedOfficialFirstName": "RAMTIN",
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"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "949-510-0225",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223G0001X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}