Provider Demographics
NPI:1912020215
Name:BUI, THUY T (DDS)
Entity Type:Individual
Prefix:DR
First Name:THUY
Middle Name:T
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 1:2421 ENCINAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5205
Mailing Address - Country:US
Mailing Address - Phone:510-865-1996
Mailing Address - Fax:510-521-2348
Practice Address - Street 1:2421 ENCINAL AVE STE A
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5205
Practice Address - Country:US
Practice Address - Phone:510-865-1996
Practice Address - Fax:510-521-2348
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD427241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice