{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "HUBERT J DORION DDS",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherOrgNameTypeCode": "6",
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"FirstLineMailingAddress": "645 EAST AERICK STREET",
"SecondLineMailingAddress": "#3",
"MailingAddressCityName": "INGLEWOOD",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90301-4881",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "323-678-4779",
"MailingAddressFaxNumber": "310-677-6786",
"FirstLinePracticeLocationAddress": "645 EAST AERICK STREET",
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"PracticeLocationAddressCityName": "INGLEWOOD",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "323-678-4779",
"PracticeLocationAddressFaxNumber": "310-677-6786",
"EnumerationDate": "01/16/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DORION",
"AuthorizedOfficialFirstName": "HUBERT",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "DENTIST",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "323-678-4779",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "15033",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}