{
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"FirstLineMailingAddress": "8540 S SEPULVEDA BLVD",
"SecondLineMailingAddress": "#700",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90045-3807",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-216-0101",
"MailingAddressFaxNumber": "310-216-1279",
"FirstLinePracticeLocationAddress": "8540 S SEPULVEDA BLVD",
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"PracticeLocationAddressTelephoneNumber": "310-216-0101",
"PracticeLocationAddressFaxNumber": "310-216-1279",
"EnumerationDate": "12/22/2008",
"LastUpdateDate": "01/25/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ORTEGA-FRASCH",
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"AuthorizedOfficialTelephoneNumber": "310-216-0101",
"Taxonomies": {
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"TaxonomyName": "Dental Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}