Active NPI
Duc Huu Truong, DMD
- Endodontics
- Hanover, MA
National Provider Identifier
1669698585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 18611
- Practice address
- 1775 Washington St
Unident Dental Center
Hanover, MA 02339 - Phone
- (781) 826-8866
- Fax
- (780) 826-1474
- NPI assigned
- Apr 18, 2007
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 18611 | MA | Primary |
Addresses
Primary practice location
1775 Washington St
Unident Dental Center
Hanover, MA 02339
Mailing address
58 East Border Road
Malden, MA 02148
Phone (781) 325-5353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0280259 | Other | MA | MASS HEALTH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18611 | MA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669698585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 EAST BORDER ROAD",
"city": "MALDEN",
"state": "MA",
"postal_code": "02148",
"telephone_number": "781-325-5353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 WASHINGTON ST",
"address_2": "UNIDENT DENTAL CENTER",
"city": "HANOVER",
"state": "MA",
"postal_code": "02339",
"telephone_number": "781-826-8866",
"fax_number": "780-826-1474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUONG",
"first_name": "DUC",
"middle_name": "HUU",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MA",
"license": "18611",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS HEALTH",
"identifier": "0280259",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hanover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.