Individual provider Active NPI

Thanh Truong, DDS

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1770693517
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22611 Issued in TX
Practice address
5824 S Hulen St
Fort Worth, TX 76132-2684
Phone
(817) 292-9500
Fax
(817) 292-0667
NPI assigned
Aug 30, 2006
Last updated
Feb 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22611 TX Primary

Addresses

Primary practice location

5824 S Hulen St
Fort Worth, TX 76132-2684

Mailing address

5824 S Hulen St
Fort Worth, TX 76132-2684
Phone (817) 292-9500

Other identifiers 1

IdentifierTypeStateIssuer
22611OtherTSB OF DENTAL EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250815001183 TX Order and Referring Only - DentistPractitioner - Dentist 9436658648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22611TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ismile Dental Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1770693517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5824 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322684",
            "telephone_number": "817-292-9500",
            "fax_number": "817-292-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5824 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761322684",
            "telephone_number": "817-292-9500",
            "fax_number": "817-292-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "THANH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "22611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSB OF DENTAL EXAMINERS",
            "identifier": "22611",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.