{
"Npi": {
"NPI": "1740455450",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MOGRE",
"FirstName": "ABHISHEK",
"MiddleName": "AVINASH",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "505 SOUTH DR",
"SecondLineMailingAddress": "STE 4",
"MailingAddressCityName": "MOUNTAIN VIEW",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94040-4210",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "650-965-2222",
"MailingAddressFaxNumber": "650-965-3274",
"FirstLinePracticeLocationAddress": "505 SOUTH DR",
"SecondLinePracticeLocationAddress": "STE 4",
"PracticeLocationAddressCityName": "MOUNTAIN VIEW",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94040-4210",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-965-2222",
"PracticeLocationAddressFaxNumber": "650-965-3274",
"EnumerationDate": "04/23/2008",
"LastUpdateDate": "03/27/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223S0112X",
"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "60062",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}