Individual provider Active NPI

Kevin Thuc Truong, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1477611762
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54640 Issued in CA
Practice address
2320 S Robertson Blvd
102
Los Angeles, CA 90034-2060
Phone
(310) 839-8831
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 54640 CA Primary

Addresses

Primary practice location

2320 S Robertson Blvd
102
Los Angeles, CA 90034-2060

Mailing address

2560 S Barrington Ave
201
Los Angeles, CA 90064-2879
Phone (310) 268-8417

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

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1477611762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 S BARRINGTON AVE",
            "address_2": "201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642879",
            "telephone_number": "310-268-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 S ROBERTSON BLVD",
            "address_2": "102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900342060",
            "telephone_number": "310-839-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "KEVIN",
        "middle_name": "THUC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.