Active NPI
Bryan Truong, DDS, MDS
- Pediatric Dentistry
- Southaven, MS
National Provider Identifier
1184465478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 112351
- Practice address
- 2925 Nail Rd E Ste 103
Southaven, MS 38672-6715 - Phone
- (662) 893-7337
- NPI assigned
- Jun 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 112351 | MS | Primary |
| Pediatric Dentistry | 1223P0221X | 13060 | TN |
Addresses
Primary practice location
2925 Nail Rd E Ste 103
Southaven, MS 38672-6715
Mailing address
843 Vinson Rd
Hernando, MS 38632-7241
Phone (770) 861-0911
Other practice location 1
8142 Country Village Dr Ste 101
Cordova, TN 38016-2056
Phone (901) 756-4447
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Mississippi Dental Specialists, PLLC | Pediatric Dentistry | 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.
-
- Pediatric Dentistry
- Southaven, MS
- NPI 1578658373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784246400000",
"number": "1184465478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "843 VINSON RD",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386327241",
"telephone_number": "770-861-0911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2925 NAIL RD E STE 103",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386726715",
"telephone_number": "662-893-7337"
}
],
"practiceLocations": [
{
"address_1": "8142 Country Village Dr Ste 101",
"address_purpose": "LOCATION",
"city": "Cordova",
"state": "TN",
"postal_code": "380162056",
"country_code": "US",
"telephone_number": "901-756-4447",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRUONG",
"first_name": "BRYAN",
"credential": "DDS, MDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-03",
"last_updated": "2026-07-17",
"certification_date": "2026-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "MS",
"license": "112351",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TN",
"license": "13060",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.