{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ZAHRA H. EZZY D.D.S. INC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13422 NEWPORT AVE STE N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TUSTIN",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92780-3746",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-730-5600",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13422 NEWPORT AVE STE N",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TUSTIN",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-730-5600",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/26/2024",
"LastUpdateDate": "03/26/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EZZY",
"AuthorizedOfficialFirstName": "ZAHRA",
"AuthorizedOfficialMiddleName": "HANIEH",
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.D.S",
"AuthorizedOfficialTelephoneNumber": "714-730-5600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}