{
"Npi": {
"NPI": "1821519877",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "OLSON",
"FirstName": "HEATHER",
"MiddleName": "NICOLE",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1001 S MEADOWS PKWY APT 1521",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RENO",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89521-5997",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-241-7866",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6395 S MCCARRAN BLVD # B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RENO",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89509-6101",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "775-823-9419",
"PracticeLocationAddressFaxNumber": "775-823-9427",
"EnumerationDate": "06/29/2017",
"LastUpdateDate": "06/29/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "6917",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "6917",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}