{
"Npi": {
"NPI": "1366501579",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SILVIA T. BORISSON D.D.S., 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": "4654 E AVENUE S",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "PALMDALE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93552-4454",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "661-285-4001",
"MailingAddressFaxNumber": "661-285-2282",
"FirstLinePracticeLocationAddress": "4654 E AVENUE S",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "PALMDALE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93552-4454",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "661-285-4001",
"PracticeLocationAddressFaxNumber": "661-285-2282",
"EnumerationDate": "12/06/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BORISSON",
"AuthorizedOfficialFirstName": "SILVIA",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S",
"AuthorizedOfficialTelephoneNumber": "661-285-4001",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "49280",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}