Individual provider Active NPI

Brian Tuan Luong, D.M.D., M.B.A.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Santa Ana, CA
National Provider Identifier
1568868149
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
63276 Issued in CA
Practice address
715 S Main St
Santa Ana, CA 92701-5717
Phone
(714) 647-0797
NPI assigned
Nov 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 126 NE
General Practice Dentistry 1223G0001X 126 NE
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 126 NE
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 63276 CA Primary

Addresses

Primary practice location

715 S Main St
Santa Ana, CA 92701-5717

Mailing address

9702 Shannon Ave
Garden Grove, CA 92841-2652
Phone (714) 366-2032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170301002151 CA Order and Referring Only - Other (Non-Physician) 2163706607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
63276CAMDClinical Social Worker
126NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian T. Luong DMD Mba Ms PC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Luong Lee Dental Partnership Orthodontics and Dentofacial Orthopedics Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1568868149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9702 SHANNON AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928412652",
            "telephone_number": "714-366-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S MAIN ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015717",
            "telephone_number": "714-647-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "BRIAN",
        "middle_name": "TUAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-10",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "126",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "126",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NE",
            "license": "126",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "63276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.