{
"Npi": {
"NPI": "1437523883",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUNG KOO KIM,DDS,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": "2266 NORTE VISTA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHINO HILLS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91709-1305",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "18887 COLIMA RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROWLAND HEIGHTS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91748-2940",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-810-8826",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/23/2015",
"LastUpdateDate": "11/23/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KIM",
"AuthorizedOfficialFirstName": "SUNG",
"AuthorizedOfficialMiddleName": "KOO",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "626-810-8826",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "50764",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}