Provider Demographics
NPI:1891121158
Name:KHANGVI BUI D.D.S., P.C.
Entity Type:Organization
Organization Name:KHANGVI BUI D.D.S., P.C.
Other - Org Name:ICARE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KHANG
Authorized Official - Middle Name:VUTUAN
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-528-7571
Mailing Address - Street 1:11403 ASHFORD PNE
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6179
Mailing Address - Country:US
Mailing Address - Phone:832-528-7571
Mailing Address - Fax:281-277-7807
Practice Address - Street 1:11611 WEST AIRPORT, SUITE F
Practice Address - Street 2:
Practice Address - City:MEADOWS PLACE
Practice Address - State:TX
Practice Address - Zip Code:77477-3042
Practice Address - Country:US
Practice Address - Phone:832-528-7571
Practice Address - Fax:281-277-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX254301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty