{
"Npi": {
"NPI": "1265883706",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COHEN",
"FirstName": "MAHYAR",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "KOHANBASH",
"OtherFirstName": "MAHYAR",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5243 YARMOUTH AVE",
"SecondLineMailingAddress": "UNIT 22",
"MailingAddressCityName": "ENCINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91316-3134",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-595-4088",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5243 YARMOUTH AVE",
"SecondLinePracticeLocationAddress": "UNIT 22",
"PracticeLocationAddressCityName": "ENCINO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91316-3109",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-595-4088",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/27/2016",
"LastUpdateDate": "06/27/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "100266",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}