{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "BRACE YOURSELF ORTHODONTICS, INC. / JAY PAREKH DDS, MS",
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"FirstLineMailingAddress": "5526 WINDING CAPE WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MASON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "45040-5017",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "513-335-2342",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1937 CENTRAL AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ASHLAND",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41101-7747",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-329-0038",
"PracticeLocationAddressFaxNumber": "606-329-0058",
"EnumerationDate": "04/02/2012",
"LastUpdateDate": "11/21/2013",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PAREKH",
"AuthorizedOfficialFirstName": "JAY",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "513-335-2342",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "8434",
"LicenseNumberStateCode": "KY",
"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."
}
}
}
}