{
"Npi": {
"NPI": "1265613160",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BAEK Y. CHOUNG, D.D.S., INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8653 FLORENCE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DOWNEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90240-4032",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-622-0066",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8653 FLORENCE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DOWNEY",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90240-4032",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-622-0066",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/19/2007",
"LastUpdateDate": "11/19/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHOUNG",
"AuthorizedOfficialFirstName": "BAEK",
"AuthorizedOfficialMiddleName": "YOUNG",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "562-622-0066",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "46770",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}