{
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "TOMMY C LE DDS, A PROFESSIONAL DENTAL CORPORATION",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "1641 E 17TH ST",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "SANTA ANA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92705-8535",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-542-7400",
"MailingAddressFaxNumber": "714-543-3536",
"FirstLinePracticeLocationAddress": "1641 E 17TH ST",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "SANTA ANA",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-542-7400",
"PracticeLocationAddressFaxNumber": "714-543-3536",
"EnumerationDate": "02/17/2014",
"LastUpdateDate": "02/17/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LE",
"AuthorizedOfficialFirstName": "TOMMY",
"AuthorizedOfficialMiddleName": "CUONG",
"AuthorizedOfficialTitle": "DENTIST",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "714-454-3340",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "57630",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}