Provider Demographics
NPI:1356663892
Name:TRUONG, ANNE X (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:X
Last Name:TRUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4147
Mailing Address - Country:US
Mailing Address - Phone:212-755-3414
Mailing Address - Fax:212-308-7924
Practice Address - Street 1:400 E 56TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4147
Practice Address - Country:US
Practice Address - Phone:212-755-3414
Practice Address - Fax:212-308-7924
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0554081223G0001X
PADS038140122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist