{
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"OrgName": "RODNEY RASTEGAR DDS PLLC",
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"FirstLineMailingAddress": "23 BOND STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREAT NECK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11021",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-482-0329",
"MailingAddressFaxNumber": "516-482-0401",
"FirstLinePracticeLocationAddress": "601 FRANKLIN AVE",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "GARDEN CITY",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11530",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-741-4415",
"PracticeLocationAddressFaxNumber": "516-741-4417",
"EnumerationDate": "12/15/2009",
"LastUpdateDate": "01/13/2016",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVILA",
"AuthorizedOfficialFirstName": "JENNIFER",
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"AuthorizedOfficialTelephoneNumber": "516-741-4415",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223S0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "048692",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}