=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538063136
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRAPEVINE DENTIST PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 W NORTHWEST HWY STE 200
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-8135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-251-4888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1417 LAUREL GREEN CT
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76005-1351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 682-553-8453
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER DENTIST
-----------------------------------------------------
Name | DR. DOAN HUU BUI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 682-553-8453
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------