{
"Npi": {
"NPI": "1871014795",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARYAM HAERI, DDS, PLLC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11800 OLD GEORGETOWN RD APT 1426",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCKVILLE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20852-2654",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-439-1212",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1145 19TH ST NW STE 508",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WASHINGTON",
"PracticeLocationAddressStateName": "DC",
"PracticeLocationAddressPostalCode": "20036-3715",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "202-826-7000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/30/2017",
"LastUpdateDate": "06/30/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARI",
"AuthorizedOfficialFirstName": "MARYAM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/ GENERAL DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "202-826-7000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "DEN1000289",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}