Healthcare Provider Details

I. General information

NPI: 1407677206
Provider Name (Legal Business Name): BUMI DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 N LEE TREVINO DR STE B
EL PASO TX
79936-5177
US

IV. Provider business mailing address

1612 N LEE TREVINO DR STE B
EL PASO TX
79936-5177
US

V. Phone/Fax

Practice location:
  • Phone: 915-591-2525
  • Fax:
Mailing address:
  • Phone: 915-591-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SONIA NAJIB
Title or Position: OWNER/DENTIST
Credential: DR
Phone: 575-302-0427