Active NPI
Manh CHI Truong, DMD
- Dentist
- Portland, OR
National Provider Identifier
1093961534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7961
- Practice address
- 4410 SE 82ND Ave Unit 2050
Portland, OR 97266-2955 - Phone
- (503) 771-0081
- Fax
- (503) 772-2272
- NPI assigned
- Aug 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7961 | OR | Primary |
Addresses
Primary practice location
4410 SE 82ND Ave Unit 2050
Portland, OR 97266-2955
Mailing address
1915 Dorothy Ave. Apt 5
Longview, WA 98632
Phone (408) 390-1384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7961 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastport Plaza Dental P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Portland, OR
- NPI 1699927863
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218758400000",
"number": "1093961534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1915 DOROTHY AVE. APT 5",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "98632",
"telephone_number": "408-390-1384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 SE 82ND AVE UNIT 2050",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972662955",
"telephone_number": "503-771-0081",
"fax_number": "503-772-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUONG",
"first_name": "MANH",
"middle_name": "CHI",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-15",
"last_updated": "2008-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D7961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.