{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "AUBREY DENTAL PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "6624 RIVERSIDE DRIVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLANO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75024",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-244-6287",
"MailingAddressFaxNumber": "469-715-6608",
"FirstLinePracticeLocationAddress": "26745 E. UNIVERSITY DR. #110",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AUBREY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76227",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "469-715-6622",
"PracticeLocationAddressFaxNumber": "469-715-6608",
"EnumerationDate": "06/17/2015",
"LastUpdateDate": "05/22/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUI",
"AuthorizedOfficialFirstName": "KATHY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DENTIST/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "469-715-6622",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "23861",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}