Provider Demographics
NPI:1154400273
Name:BUI, DUNG VIET (DMD)
Entity type:Individual
Prefix:
First Name:DUNG
Middle Name:VIET
Last Name:BUI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7925
Mailing Address - Country:US
Mailing Address - Phone:702-566-5509
Mailing Address - Fax:702-566-5198
Practice Address - Street 1:70 E HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015
Practice Address - Country:US
Practice Address - Phone:702-566-5509
Practice Address - Fax:702-566-5198
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV47011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice