{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "DUNDEE DENTAL SMILE PC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "2505 W.SCHAUMBURG ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SCHAUMBURG",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60194",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-891-9999",
"MailingAddressFaxNumber": "847-891-9008",
"FirstLinePracticeLocationAddress": "27 SOUTH WESTERN AVE",
"SecondLinePracticeLocationAddress": "UNIT # E",
"PracticeLocationAddressCityName": "CARPENTERVILLE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60110",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "312-608-0246",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/02/2012",
"LastUpdateDate": "10/02/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHOI",
"AuthorizedOfficialFirstName": "KYUNG",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "312-608-0246",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "019027237",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}