Individual provider Active NPI

Bryan Truong, DDS, MDS

  • Pediatric Dentistry
  • Southaven, MS
National Provider Identifier
1184465478
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
112351 Issued in MS
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

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 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

OrganizationSpecialtyStatusNew patients
North Mississippi Dental Specialists, PLLC Pediatric Dentistry PastSince May 29, 2022 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.

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.

Verify at the official NPI Registry.