Individual provider Active NPI

An Van Truong, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Irvine, CA
National Provider Identifier
1710225446
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
63395 Issued in CA
Practice address
3963 Portola Pkwy
Irvine, CA 92602-0833
Phone
(714) 544-5544
Fax
(714) 544-5599
NPI assigned
Jan 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 63395 CA Primary

Addresses

Primary practice location

3963 Portola Pkwy
Irvine, CA 92602-0833

Mailing address

2521 Whispering TRL
Irvine, CA 92602-0826
Phone (323) 202-0397

Other practice location 1

1122 E Lincoln Ave Ste 210
Orange, CA 92865-1909
Phone (657) 650-1221

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915002611 CA Order and Referring Only - DentistPractitioner - Dentist 0244547891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peter an Truong, DDS, Ms Inc. Orthodontics and Dentofacial Orthopedics CurrentSince May 7, 2024 Accepting new patients

Locations

3963 Portola Pkwy
Irvine, CA 92602
Phone (714) 544-5544

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.

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1710225446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 WHISPERING TRL",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926020826",
            "telephone_number": "323-202-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3963 PORTOLA PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926020833",
            "telephone_number": "714-544-5544",
            "fax_number": "714-544-5599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 E Lincoln Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928651909",
            "country_code": "US",
            "telephone_number": "657-650-1221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "AN",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-31",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "63395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.