Healthcare Provider Details

I. General information

NPI: 1679982094
Provider Name (Legal Business Name): MICHAEL HY BUU MA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 N ALTADENA DR
PASADENA CA
91107-1430
US

IV. Provider business mailing address

2540 WHITNEY DR
ALHAMBRA CA
91803-4427
US

V. Phone/Fax

Practice location:
  • Phone: 626-797-6778
  • Fax:
Mailing address:
  • Phone: 801-209-9887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS101469
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: