{
"Npi": {
"NPI": "1316168263",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SORONGON",
"FirstName": "DIA",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DDS",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2319 ARCHWOOD LN",
"SecondLineMailingAddress": "123",
"MailingAddressCityName": "SIMI VALLEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93063-6538",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-781-1533",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7068 SEPULVEDA BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VAN NUYS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91405-2926",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-781-1533",
"PracticeLocationAddressFaxNumber": "818-781-2877",
"EnumerationDate": "05/01/2007",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "50737",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}