Provider Demographics
NPI:1154480952
Name:BUI, THANHHA (DDS)
Entity Type:Individual
Prefix:
First Name:THANHHA
Middle Name:
Last Name:BUI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5394 WALNUT AVE STE E
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-2544
Mailing Address - Country:US
Mailing Address - Phone:949-552-1757
Mailing Address - Fax:949-552-5821
Practice Address - Street 1:5394 WALNUT AVE STE E
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-2544
Practice Address - Country:US
Practice Address - Phone:949-552-1757
Practice Address - Fax:949-552-5821
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA407941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice