Individual provider Active NPI

Huong Linda Truong, DMD

  • Dentist
  • Port St Lucie, FL
National Provider Identifier
1255783783
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN22045 Issued in FL
Practice address
10696 SW Village Pkwy
Port St Lucie, FL 34987-2358
Phone
(772) 380-4490
NPI assigned
Jul 8, 2016
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D10739 OR
Dentist 122300000X DN22045 FL Primary

Addresses

Primary practice location

10696 SW Village Pkwy
Port St Lucie, FL 34987-2358

Mailing address

10696 SW Village Pkwy
Port St Lucie, FL 34987-2358
Phone (772) 380-4490

Other practice location 1

1175 Mount Hood Ave
Woodburn, OR 97071-9060
Phone (503) 982-2000

Other practice location 2

1384 SW Saint Lucie West Blvd
Port St Lucie, FL 34986-2109
Phone (772) 249-0488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20161227000682 FL Order and Referring Only - DentistPractitioner - Dentist 7315228756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10739ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Syd Associates, PA PastSince Jun 26, 2022 Accepting new patients
Professional Dental Alliance of Florida, PLLC PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1255783783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10696 SW VILLAGE PKWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872358",
            "telephone_number": "772-380-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10696 SW VILLAGE PKWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872358",
            "telephone_number": "772-380-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 Mount Hood Ave",
            "address_purpose": "LOCATION",
            "city": "Woodburn",
            "state": "OR",
            "postal_code": "970719060",
            "country_code": "US",
            "telephone_number": "503-982-2000",
            "fax_number": "503-982-0660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1384 SW Saint Lucie West Blvd",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349862109",
            "country_code": "US",
            "telephone_number": "772-249-0488",
            "fax_number": "772-249-4695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "HUONG",
        "middle_name": "LINDA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10739",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.