Dr. Marie Yvette Mandilag Buan Sr., DDS
Dentist, General Practice in Buena Park, CA. Individual provider (NPI-1).
NPI number1164569950
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1164569950
- Entity type
- Individual (NPI-1)
- Name
- Dr. Marie Yvette Mandilag Buan Sr.
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 31, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 44294 | CA | Yes |
Practice location
7855 La Palma AveSte.2
Buena Park, CA 90620-1951
Phone 714-736-0501 · Fax 714-736-0545
Mailing address
7855 La Palma Ave Ste 2Buena Park, CA 90620-1957
Phone 714-736-0501 · Fax 714-736-0545
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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