{
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"FirstLineMailingAddress": "5509 PLEASANT VALLEY DR",
"SecondLineMailingAddress": "SUITE 90B",
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"MailingAddressPostalCode": "75023-5248",
"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "972-398-0021",
"FirstLinePracticeLocationAddress": "5509 PLEASANT VALLEY DR",
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"PracticeLocationAddressFaxNumber": "972-398-0021",
"EnumerationDate": "03/28/2007",
"LastUpdateDate": "08/22/2020",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHULYAK",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Dentistry",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}