Provider Demographics
NPI:1730202680
Name:DO, BUU-CHAU THI (DMD)
Entity type:Individual
Prefix:
First Name:BUU-CHAU
Middle Name:THI
Last Name:DO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11303 NE 128TH ST APT B303
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-6360
Mailing Address - Country:US
Mailing Address - Phone:425-749-8102
Mailing Address - Fax:
Practice Address - Street 1:33600 6TH AVE S STE 102
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6743
Practice Address - Country:US
Practice Address - Phone:253-838-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010309122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist