{
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "16118 SEEKERS ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN ANTONIO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78255-3311",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "210-685-7420",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11345 ALAMO RANCH PKWY STE 202",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN ANTONIO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78253-6442",
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"PracticeLocationAddressTelephoneNumber": "210-688-9190",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/06/2019",
"LastUpdateDate": "11/06/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IGUN",
"AuthorizedOfficialFirstName": "ADEPEJU",
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"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "210-685-7420",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}