Provider Demographics
NPI:1083308837
Name:BUI, DUY XUAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DUY
Middle Name:XUAN
Last Name:BUI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 PRAY ST
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-5070
Mailing Address - Country:US
Mailing Address - Phone:714-507-5496
Mailing Address - Fax:
Practice Address - Street 1:3775 BEACON AVE STE 100
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1466
Practice Address - Country:US
Practice Address - Phone:510-791-0971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1058091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics