{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "KARIM ELNOKRASHY DENTAL CORPORATION",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgNameTypeCode": "6",
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"FirstLineMailingAddress": "1503 E MARCH LN",
"SecondLineMailingAddress": "SUITE #B",
"MailingAddressCityName": "STOCKTON",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95210-5600",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "209-957-8828",
"MailingAddressFaxNumber": "209-957-8811",
"FirstLinePracticeLocationAddress": "1503 E MARCH LN",
"SecondLinePracticeLocationAddress": "SUITE #B",
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"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "209-957-8828",
"PracticeLocationAddressFaxNumber": "209-957-8811",
"EnumerationDate": "06/02/2008",
"LastUpdateDate": "06/02/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ELNOKRASHY",
"AuthorizedOfficialFirstName": "KARIM",
"AuthorizedOfficialMiddleName": "AHMAD SAMY",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "209-957-8828",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "50906",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}