Provider Demographics
NPI:1578637955
Name:DANG, BUU TAN (DMD)
Entity type:Individual
Prefix:DR
First Name:BUU
Middle Name:TAN
Last Name:DANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 A-HARWIN DR.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:281-657-1500
Mailing Address - Fax:281-657-1505
Practice Address - Street 1:10000 A-HARWIN DR.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:281-657-1500
Practice Address - Fax:281-657-1505
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1208027-05Medicaid