{
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"FirstLineMailingAddress": "23520 OVERLAND DR",
"SecondLineMailingAddress": "SUITE 134",
"MailingAddressCityName": "DULLES",
"MailingAddressStateName": "VA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "23520 OVERLAND DR",
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"EnumerationDate": "03/10/2008",
"LastUpdateDate": "03/10/2008",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "HUSSEIN",
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"AuthorizedOfficialMiddleName": "MANSOUR",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
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"TaxonomyName": "General Practice Dentistry",
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"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}