NPIMap

Organization Active NPI

Kurt Truong, DDS, MSD, PLLC

Doing business as Pleasant Valley Pediatric Dentistry

  • Dental Clinic/Center
  • Vancouver, WA
National Provider Identifier
1093268161
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE60299879 Issued in WA
Legal business name
KURT TRUONG, DDS, MSD, PLLC
Doing business as
Pleasant Valley Pediatric Dentistry
Practice address
14201 NE 20TH Ave
Suite 3102
Vancouver, WA 98686-6410
Phone
(360) 573-3176
Fax
(360) 571-3276
NPI assigned
Jul 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
Dr. Kurt Truong, DDS, MSDNPI 1285998336
Title
Owner
Phone
(360) 573-3176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE60299879 WA Primary

Addresses

Primary practice location

14201 NE 20TH Ave
Suite 3102
Vancouver, WA 98686-6410

Mailing address

14201 NE 20TH Ave
Suite 3102
Vancouver, WA 98686-6410
Phone (360) 573-3176

Other identifiers 1

IdentifierTypeStateIssuer
2049798MedicaidWA

Other names 1

  • Pleasant Valley Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1093268161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 NE 20TH AVE",
            "address_2": "SUITE 3102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866410",
            "telephone_number": "360-573-3176",
            "fax_number": "360-571-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 NE 20TH AVE",
            "address_2": "SUITE 3102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866410",
            "telephone_number": "360-573-3176",
            "fax_number": "360-571-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KURT TRUONG, DDS, MSD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "TRUONG",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-573-3176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE60299879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2049798",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pleasant Valley Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.