{
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"FirstLineMailingAddress": "17037 BROOKHURST ST STE 4",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FOUNTAIN VALLEY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92708-3623",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-962-2300",
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"FirstLinePracticeLocationAddress": "17037 BROOKHURST ST STE 4",
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"PracticeLocationAddressCityName": "FOUNTAIN VALLEY",
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"PracticeLocationAddressTelephoneNumber": "714-962-2300",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/09/2017",
"LastUpdateDate": "11/09/2017",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOISIUC",
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"AuthorizedOfficialCredential": "DNTIST",
"AuthorizedOfficialTelephoneNumber": "714-300-3878",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dental Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}