{
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"OrgName": "NIHAR D TANNA DDS MS INCORPORATED",
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"FirstLineMailingAddress": "27035 BIG HORN MOUNTAIN WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YORBA LINDA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92887-4211",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "2569 CHINO HILLS PKWY UNIT K",
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"PracticeLocationAddressCityName": "CHINO HILLS",
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"PracticeLocationAddressTelephoneNumber": "909-464-9348",
"PracticeLocationAddressFaxNumber": "909-464-9239",
"EnumerationDate": "05/18/2017",
"LastUpdateDate": "04/29/2020",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "TANNA",
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"AuthorizedOfficialCredential": "DDS.,MS.",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "49812",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}