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General NPI Number Information
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NPI Number | 1831404417
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Entity Type | Individual
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Provider Name | SHAWN XUAN BUI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2010
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 905 N JUPITER RD STE 180
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City | RICHARDSON
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State | TX
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Zip | 75081-7713
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Country | US
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Telephone | 972-234-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 3125 SANTA ANNA AVE
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City | DALLAS
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State | TX
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Zip | 75228-1755
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Country | US
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Telephone | 214-924-3160
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25625
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License Number State | TX
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