{
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"FirstLineMailingAddress": "3136 SQUALICUM PKWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELLINGHAM",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98225-1954",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-671-4859",
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"FirstLinePracticeLocationAddress": "3136 SQUALICUM PKWY",
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"PracticeLocationAddressCityName": "BELLINGHAM",
"PracticeLocationAddressStateName": "WA",
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"EnumerationDate": "05/28/2018",
"LastUpdateDate": "05/28/2018",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "ESMAIL",
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"AuthorizedOfficialCredential": "DDS, MD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery Clinic/Center",
"LicenseNumber": "DE60150330",
"LicenseNumberStateCode": "WA",
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}
},
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}
}