=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073802195
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NHAN HIEN DENTISTRY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2011
-----------------------------------------------------
Last Update Date | 03/29/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12148 BELLAIRE BLVD SUITE 102
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77072-2315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-561-7200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12148 BELLAIRE BLVD SUITE 102
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77072-2315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-561-7200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PERIODONTIST/DENTIST
-----------------------------------------------------
Name | DR. DINH XUAN BUI
-----------------------------------------------------
Credential | DDS, MS
-----------------------------------------------------
Telephone | 281-579-6066
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0300X
-----------------------------------------------------
Taxonomy Name | Periodontics
-----------------------------------------------------
License Number | 18292
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------