{
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"FirstLineMailingAddress": "8320 DESOTO AVE",
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"MailingAddressCityName": "CANOGA PARK",
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"MailingAddressPostalCode": "91304-1746",
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"MailingAddressTelephoneNumber": "818-883-1234",
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"PracticeLocationAddressFaxNumber": "818-883-9781",
"EnumerationDate": "02/20/2008",
"LastUpdateDate": "01/09/2017",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SEPEHRIPOUR",
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"AuthorizedOfficialTitle": "OWNER DENTIST",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
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"TaxonomyName": "General Practice Dentistry",
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"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}
}
}