Bao Truong, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

12013784A Issued in IN

Practice address

1738 165TH St
Hammond, IN 46320-2814

Phone

(219) 844-8000

NPI assigned

Jul 25, 2019

Last updated

Nov 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pro Dental in 1 PC

  dba Destiny Dental of Hammond

  • General Practice Dentistry
  • Hammond, IN
  • NPI 1316774698
  NPD

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1144874470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 165TH ST",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202814",
            "telephone_number": "219-844-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1738 165TH ST",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202814",
            "telephone_number": "219-844-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "BAO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032259",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013784A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendal Rose Travis, M.A., ED.S.
• TRC - Indiana LLC (Comprehensive Renal Care Hammond)
• Terry Steven Trepper, PH.D.
• Matthew Lorenzo Trinidad, DC
• Triumph Hospital Northwest Indiana. LLC (Kindred Hospital Northwest Indiana)
• Tracy Michelle Tucker, FNP
• Falvy Hakan Tunca, MD
• Mohamed Turkmani, MD
• United Dental Centers
• University Eye Care SC

• Dentist in Hammond, IN
• Providers in Hammond, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.