Healthcare Provider Details

I. General information

NPI: 1952919177
Provider Name (Legal Business Name): LAM BUI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 WESEL BLVD
HAGERSTOWN MD
21740-2503
US

IV. Provider business mailing address

42702 BURBANK TER
STERLING VA
20166-2742
US

V. Phone/Fax

Practice location:
  • Phone: 240-219-6612
  • Fax:
Mailing address:
  • Phone: 703-929-7838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS042806
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number18630
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401417127
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: