{
"Npi": {
"NPI": "1891903084",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MAHIN G FARZIN DDS INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "220 NEWPORT CENTER DR",
"SecondLineMailingAddress": "#3",
"MailingAddressCityName": "NEWPORT BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92660-7506",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-274-2799",
"MailingAddressFaxNumber": "949-759-1871",
"FirstLinePracticeLocationAddress": "220 NEWPORT CENTER DR",
"SecondLinePracticeLocationAddress": "#3",
"PracticeLocationAddressCityName": "NEWPORT BEACH",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92660-7506",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "949-274-2799",
"PracticeLocationAddressFaxNumber": "949-759-1871",
"EnumerationDate": "05/19/2007",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FARZIN",
"AuthorizedOfficialFirstName": "MAHIN",
"AuthorizedOfficialMiddleName": "G",
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "949-274-2799",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "52980",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}