{
"Npi": {
"NPI": "1740741073",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRACES PLUS PC",
"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": "1916 NINTH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST THOMAS",
"MailingAddressStateName": "VI",
"MailingAddressPostalCode": "00802-2640",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "340-776-0030",
"MailingAddressFaxNumber": "340-774-9760",
"FirstLinePracticeLocationAddress": "1916 NINTH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ST THOMAS",
"PracticeLocationAddressStateName": "VI",
"PracticeLocationAddressPostalCode": "00802-2640",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "340-776-0030",
"PracticeLocationAddressFaxNumber": "340-774-9760",
"EnumerationDate": "03/28/2019",
"LastUpdateDate": "09/04/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CONNOR",
"AuthorizedOfficialFirstName": "TREVOR",
"AuthorizedOfficialMiddleName": "A. C",
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "340-776-0030",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}