{
"Npi": {
"NPI": "1720476229",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRANDY R. BUCKNER, DDS, PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
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"FirstLineMailingAddress": "1170 US HWY 1",
"SecondLineMailingAddress": "SUITE100/110",
"MailingAddressCityName": "YOUNGSVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27596",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-452-6458",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1170 US 1 HWY",
"SecondLinePracticeLocationAddress": "STE 110",
"PracticeLocationAddressCityName": "YOUNGSVILLE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27596-9020",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-452-6458",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/06/2015",
"LastUpdateDate": "01/06/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUCKNER",
"AuthorizedOfficialFirstName": "BRANDY",
"AuthorizedOfficialMiddleName": "RENEE",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "919-452-6458",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "8953",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}