{
"Npi": {
"NPI": "1619122561",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ALAMEDA COUNTY PUBLIC HEALTH",
"ParentOrgTIN": null,
"OrgName": "ALAMEDA COUNTY OFFICE OF DENTAL HEALTH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1100 SAN LEANDRO BLVD STE 400",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN LEANDRO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94577-1670",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "510-208-5910",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1100 SAN LEANDRO BLVD STE 400",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN LEANDRO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94577-1670",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-208-5910",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/19/2008",
"LastUpdateDate": "09/12/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RUBIO MAMURI",
"AuthorizedOfficialFirstName": "AURORA ISABEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "REGISTERED DENTAL ASSISTANT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RDA",
"AuthorizedOfficialTelephoneNumber": "510-912-9093",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}