Provider Demographics
NPI:1689870834
Name:BUI, THINH VAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:THINH
Middle Name:VAN
Last Name:BUI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18832 SOLEDAD CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-3772
Mailing Address - Country:US
Mailing Address - Phone:661-299-1126
Mailing Address - Fax:661-299-9263
Practice Address - Street 1:18832 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-3772
Practice Address - Country:US
Practice Address - Phone:661-299-1126
Practice Address - Fax:661-299-9263
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA497291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice