{
"Npi": {
"NPI": "1285075960",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR AQEELA SYEDA SHAH DDS INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3839 W 1ST ST",
"SecondLineMailingAddress": "B-1",
"MailingAddressCityName": "SANTA ANA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92703-4075",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-554-5062",
"MailingAddressFaxNumber": "714-554-5063",
"FirstLinePracticeLocationAddress": "3839 W 1ST ST",
"SecondLinePracticeLocationAddress": "B-1",
"PracticeLocationAddressCityName": "SANTA ANA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92703-4075",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-554-5062",
"PracticeLocationAddressFaxNumber": "714-554-5063",
"EnumerationDate": "07/10/2013",
"LastUpdateDate": "07/10/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHAH",
"AuthorizedOfficialFirstName": "AQEELA",
"AuthorizedOfficialMiddleName": "SYEDA",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "714-554-5062",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "58179",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}