Provider Demographics
NPI:1184078255
Name:TUYET-VAN THI BUI, DDS, INC.
Entity type:Organization
Organization Name:TUYET-VAN THI BUI, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VAN
Authorized Official - Middle Name:THI
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-536-5618
Mailing Address - Street 1:4330 BARRANCA PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4781
Mailing Address - Country:US
Mailing Address - Phone:949-536-5618
Mailing Address - Fax:
Practice Address - Street 1:4330 BARRANCA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4781
Practice Address - Country:US
Practice Address - Phone:949-536-5618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30491122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA528437Medicare PIN