Active NPI
Bradley Dinh Truong, DMD
- General Practice Dentistry
National Provider Identifier
1609437797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7251
- Practice address
- CMR 402 Unit 33100
Apo, AE 09180 - Phone
- (314) 590-1515
- NPI assigned
- Jun 27, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7251 | NV | Primary |
Addresses
Primary practice location
CMR 402 Unit 33100
Apo, AE 09180
Mailing address
CMR 467 Box 6323
Apo, AE 09096-0064
Phone (832) 454-7485
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191017002598 | NV | Order and Referring Only - Dentist | 3577894864 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7251 | NV | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mugleston Macdonald Rach Modern Dentistry, PC | 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.
-
dba Mugleston MacDonald Ranch Modern Dentistry
- Dentist
- Henderson, NV
- NPI 1346675386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1609437797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "CMR 467 BOX 6323",
"city": "APO",
"state": "AE",
"postal_code": "090960064",
"telephone_number": "832-454-7485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "MIL",
"address_1": "CMR 402 UNIT 33100",
"city": "APO",
"state": "AE",
"postal_code": "09180",
"telephone_number": "314-590-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUONG",
"first_name": "BRADLEY",
"middle_name": "DINH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-27",
"last_updated": "2022-03-21",
"certification_date": "2022-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "7251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.