{
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"FirstLineMailingAddress": "2808 VILLAGE WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TRENT WOODS",
"MailingAddressStateName": "NC",
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"PracticeLocationAddressFaxNumber": "252-633-3922",
"EnumerationDate": "02/08/2016",
"LastUpdateDate": "02/08/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCDONOUGH",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "D.D.S., M.S.",
"AuthorizedOfficialTelephoneNumber": "252-633-1631",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Periodontics",
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"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}