Joseph Phuoc Bui DMD Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54638 Issued in CA

Legal business name

JOSEPH PHUOC BUI DMD INC

Doing business as

Bella Terra Dental

Practice address

1110 W Kettleman LN
Ste 47
Lodi, CA 95240-6031

Phone

(209) 224-8104

NPI assigned

Jul 10, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joseph Bui, DMD

Title

Ceo/Managing Dentist

Phone

(209) 518-6315

Specialties & licenses 1

Addresses

Other names 1

• Bella Terra Dental Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1255715157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W KETTLEMAN LN",
            "address_2": "SUITE 47",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952406031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W KETTLEMAN LN",
            "address_2": "STE 47",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952406031",
            "telephone_number": "209-224-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH PHUOC BUI DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO/MANAGING DENTIST",
        "authorized_official_telephone_number": "209-518-6315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Terra Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Selena Marie Johnson
• Kimberly Lynn Jones, P.T. ASSISTANT
• Stacey Ann Jones
• Jeff Jordan
• Joseph Gayagoy MD a Professional Corporation
• Aarti Kumar Joseph, FNP
• Junoon LLC
• Gayathri Devi Kalva, M.D.
• Micky Kammerer, FNP-C
• Brian Hiroshi Kanegawa, D.D.S.

• General Practice Dentistry in Lodi, CA
• Providers in Lodi, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.