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General NPI Number Information
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NPI Number | 1003883422
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Entity Type | Individual
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Provider Name | LOANANH THI BUI D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 4280 BEE RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34233-2563
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Country | US
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Telephone | 941-363-6381
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Fax |
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Provider Business Mailing Address
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Address Line | 4280 BEE RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34233-2563
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 010043
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DI02487600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN19207
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 010043
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN 19207
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License Number State | FL
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