Provider Demographics
NPI:1386979706
Name:BUI, QUYNH N (DMD)
Entity type:Individual
Prefix:
First Name:QUYNH
Middle Name:N
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 1:2712 GILHAM WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2524
Mailing Address - Country:US
Mailing Address - Phone:408-622-5677
Mailing Address - Fax:408-622-5687
Practice Address - Street 1:2569 S KING RD
Practice Address - Street 2:SUITE C6
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1895
Practice Address - Country:US
Practice Address - Phone:408-622-5677
Practice Address - Fax:408-622-5687
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-03
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA588931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice