{
"Npi": {
"NPI": "1508198615",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NGUYEN & DO DENTAL CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "15775 IMPERIAL HWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LA MIRADA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90638-2510",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-943-4488",
"MailingAddressFaxNumber": "562-943-4422",
"FirstLinePracticeLocationAddress": "15775 IMPERIAL HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LA MIRADA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90638-2510",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-943-4488",
"PracticeLocationAddressFaxNumber": "562-943-4422",
"EnumerationDate": "02/01/2010",
"LastUpdateDate": "02/01/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NGUYEN",
"AuthorizedOfficialFirstName": "DAN",
"AuthorizedOfficialMiddleName": "CONG",
"AuthorizedOfficialTitle": "ORTHODONTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S",
"AuthorizedOfficialTelephoneNumber": "562-943-4488",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "46308",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}