Provider Demographics
NPI:1811371818
Name:PHUI, ANDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:
Last Name:PHUI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8466 WILLOW MIST DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6152
Mailing Address - Country:US
Mailing Address - Phone:702-338-6668
Mailing Address - Fax:
Practice Address - Street 1:5590 PAINTED MIRAGE RD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4585
Practice Address - Country:US
Practice Address - Phone:702-450-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV66371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice