{
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"FirstLineMailingAddress": "7122 N CLARK ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60626-2408",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-274-9009",
"MailingAddressFaxNumber": "773-274-9009",
"FirstLinePracticeLocationAddress": "8116 CALIFORNIA AVE STE C",
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"PracticeLocationAddressCityName": "SOUTH GATE",
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"PracticeLocationAddressTelephoneNumber": "323-567-1821",
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"EnumerationDate": "07/02/2009",
"LastUpdateDate": "08/11/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARAGHI",
"AuthorizedOfficialFirstName": "HOSSEIN",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "773-274-9009",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Dentist",
"LicenseNumber": "52333",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}