Provider Demographics
NPI:1598283525
Name:BUI, RACHEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
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 1:5169 CAMINO PLAYA PORTOFINO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-1173
Mailing Address - Country:US
Mailing Address - Phone:858-610-7405
Mailing Address - Fax:
Practice Address - Street 1:950 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5208
Practice Address - Country:US
Practice Address - Phone:760-208-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist