{
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"FirstLineMailingAddress": "2620 E COLORADO BLVD",
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"MailingAddressCityName": "PASADENA",
"MailingAddressStateName": "CA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-616-3977",
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"FirstLinePracticeLocationAddress": "19500 PLUMMER ST",
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"PracticeLocationAddressCityName": "NORTHRIDGE",
"PracticeLocationAddressStateName": "CA",
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"EnumerationDate": "09/19/2025",
"LastUpdateDate": "09/19/2025",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KAVETY",
"AuthorizedOfficialFirstName": "PALLAVI",
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"AuthorizedOfficialTitle": "OWNER/DENTIST",
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"AuthorizedOfficialCredential": "D.D.S",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pediatric Dentistry",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}