Individual provider Active NPI

Ruby Truong, DMD

  • Dentist
  • Atlanta, GA
National Provider Identifier
1992105654
Registry record updated Jun 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014863 Issued in GA
Practice address
2200 Parklake Dr NE Apt 1204
Atlanta, GA 30345-2872
Phone
(678) 643-1488
NPI assigned
Sep 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN014863 GA Primary

Addresses

Primary practice location

2200 Parklake Dr NE Apt 1204
Atlanta, GA 30345-2872

Mailing address

2200 Parklake Dr NE Apt 1204
Atlanta, GA 30345-2872
Phone (678) 643-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160114002240 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517260151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN014863GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1409529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435363200000",
    "number": "1992105654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PARKLAKE DR NE APT 1204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452872",
            "telephone_number": "678-643-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PARKLAKE DR NE APT 1204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452872",
            "telephone_number": "678-643-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "RUBY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-01",
        "last_updated": "2015-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.