Provider Demographics
NPI:1972270452
Name:BUI, JAIME (DMD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:BUI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 JUSTIN RD STE 130
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2544
Mailing Address - Country:US
Mailing Address - Phone:214-516-5875
Mailing Address - Fax:
Practice Address - Street 1:3651 JUSTIN RD STE 130
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2544
Practice Address - Country:US
Practice Address - Phone:972-874-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD5510122300000X
TX37928122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist