{
"Npi": {
"NPI": "1992216717",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "CORNERSTONE DENTISTRY",
"ParentOrgTIN": null,
"OrgName": "CORNERSTONE DENTISTRY",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "14120 BEACH BLVD. #112",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESTMINISTER",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92683",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-894-0574",
"MailingAddressFaxNumber": "714-894-0345",
"FirstLinePracticeLocationAddress": "14120 BEACH BLVD. #212",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WESTMINSTER",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92683",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-894-0574",
"PracticeLocationAddressFaxNumber": "714-894-0345",
"EnumerationDate": "10/19/2017",
"LastUpdateDate": "10/19/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HWANG",
"AuthorizedOfficialFirstName": "ERIC",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "714-894-0574",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "50273",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}