{
"Npi": {
"NPI": "1568682151",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREGORY H. KUWABARA, D.D.S., INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "16960 BASTANCHURY RD",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "YORBA LINDA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92886-1711",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-986-1699",
"MailingAddressFaxNumber": "714-986-1690",
"FirstLinePracticeLocationAddress": "16960 BASTANCHURY RD",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "YORBA LINDA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92886-1711",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-986-1699",
"PracticeLocationAddressFaxNumber": "714-986-1690",
"EnumerationDate": "04/26/2007",
"LastUpdateDate": "10/06/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KUWABARA",
"AuthorizedOfficialFirstName": "GREGORY",
"AuthorizedOfficialMiddleName": "H.",
"AuthorizedOfficialTitle": "PRESIDENT, OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "714-986-1699",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "34455",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}