Healthcare Provider Details

I. General information

NPI: 1538063136
Provider Name (Legal Business Name): GRAPEVINE DENTIST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W NORTHWEST HWY STE 200
GRAPEVINE TX
76051-8135
US

IV. Provider business mailing address

1417 LAUREL GREEN CT
ARLINGTON TX
76005-1351
US

V. Phone/Fax

Practice location:
  • Phone: 817-251-4888
  • Fax:
Mailing address:
  • Phone: 682-553-8453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DOAN HUU BUI
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 682-553-8453