Provider Demographics
NPI:1194552760
Name:NAM BUI DDS PC
Entity type:Organization
Organization Name:NAM BUI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NAM
Authorized Official - Middle Name:GIANG
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-312-8551
Mailing Address - Street 1:4808 BENTREE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-1007
Mailing Address - Country:US
Mailing Address - Phone:714-312-8551
Mailing Address - Fax:
Practice Address - Street 1:2901 E KATELLA AVE STE B
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5248
Practice Address - Country:US
Practice Address - Phone:714-602-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty