Active NPI
Kristi Truong, DMD
- Dentist
- Fort Wayne, IN
National Provider Identifier
1912764176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12014959A
- Practice address
- 4041 Parnell Ave
Fort Wayne, IN 46805-1413 - Phone
- (260) 297-7511
- NPI assigned
- Mar 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12014959A | IN | Primary |
| Dentist | 122300000X | 7859 | NV |
Addresses
Primary practice location
4041 Parnell Ave
Fort Wayne, IN 46805-1413
Mailing address
10319 Pokagon Loop
Fort Wayne, IN 46818-0193
Phone (609) 947-7782
Other practice location 1
605 W Douglas Rd
Mishawaka, IN 46545-1438
Phone (574) 766-7732
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 |
|---|---|---|---|
| 12014959A | IN | MD | Dentist |
| 7859 | NV | MD | Otolaryngology/Facial Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780444800000",
"number": "1912764176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10319 POKAGON LOOP",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468180193",
"telephone_number": "609-947-7782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4041 PARNELL AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468051413",
"telephone_number": "260-297-7511"
}
],
"practiceLocations": [
{
"address_1": "605 W Douglas Rd",
"address_purpose": "LOCATION",
"city": "Mishawaka",
"state": "IN",
"postal_code": "465451438",
"country_code": "US",
"telephone_number": "574-766-7732",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRUONG",
"first_name": "KRISTI",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-04",
"last_updated": "2026-06-03",
"certification_date": "2026-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12014959A",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "7859",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.