Individual provider Active NPI

Philip Thuc Bui, DMD

  • Dentist
  • Fontana, CA
National Provider Identifier
1558084186
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108046 Issued in CA
Practice address
9610 Sierra Ave, Fontana, Ca 92335
Fontana, CA 92335
Phone
(909) 219-8700
NPI assigned
Sep 20, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
108046CAMDMental Health Counselor

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108046 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

9610 Sierra Ave, Fontana, Ca 92335
Fontana, CA 92335

Mailing address

11 Gardenia
Irvine, CA 92620-1984
Phone (714) 900-1135

Other practice location 1

14331 Euclid St
Garden Grove, CA 92843-6508
Phone (714) 554-4413

Other names 1

NPPES NPI Registry
  • Dr. NA NA NA Professional name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 20, 2022.

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1558084186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GARDENIA",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201984",
            "telephone_number": "714-900-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 SIERRA AVE, FONTANA, CA 92335",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "909-219-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14331 Euclid St",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928436508",
            "country_code": "US",
            "telephone_number": "714-554-4413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUI",
        "first_name": "PHILIP",
        "middle_name": "THUC",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NA",
            "last_name": "NA",
            "middle_name": "NA",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.