Provider Demographics
NPI:1457580375
Name:BUI, HOANG THANH (DMD)
Entity type:Individual
Prefix:DR
First Name:HOANG
Middle Name:THANH
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 1:800 LAKE CAROLYN PKWY APT 410
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4136
Mailing Address - Country:US
Mailing Address - Phone:504-210-5859
Mailing Address - Fax:
Practice Address - Street 1:3215 KIRNWOOD DR STE 102
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-4433
Practice Address - Country:US
Practice Address - Phone:972-572-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics