Individual provider Active NPI

Cong Phuoc Bui, DMD

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1689357675
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39781 Issued in TX
Practice address
730 W Stassney LN Ste 110
Austin, TX 78745-3032
Phone
(877) 800-5722
NPI assigned
Aug 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39781 TX
General Practice Dentistry 1223G0001X 39781 TX Primary

Addresses

Primary practice location

730 W Stassney LN Ste 110
Austin, TX 78745-3032

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Other practice location 1

13205 George Rd
San Antonio, TX 78230-3018
Phone (210) 767-3562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250311000680 TX Practitioner - Dentist 6800317579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39781TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Circle of Care CurrentSince Mar 17, 2025 Accepting new patients
Lone Star Circle of Care Current Accepting new patients
Lone Star Circle of Care CurrentSince Mar 17, 2025 Accepting new patients

Locations

1221 W Ben White Blvd
Ste 200B
Austin, TX 78704
Phone (512) 524-9249

730 W Stassney Ln
Ste 110
Austin, TX 78745
Phone (877) 880-8752

605 Old Austin Hwy
Bastrop, TX 78602
Phone (512) 308-6894

205 E University Ave
Ste 200
Georgetown, TX 78626
Phone (512) 686-0207

2423 Williams Dr
Georgetown, TX 78628
Phone (512) 341-8908

2423 Williams Dr
Ste 107
Georgetown, TX 78628
Phone (512) 686-0207

2411 Williams Dr
Ste 111
Georgetown, TX 78628
Phone (512) 864-1445

2120 N Mays St
Ste 430
Round Rock, TX 78664
Phone (512) 255-5120

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1689357675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W STASSNEY LN STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787453032",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13205 George Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782303018",
            "country_code": "US",
            "telephone_number": "210-767-3562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUI",
        "first_name": "CONG",
        "middle_name": "PHUOC",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "39781",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.