Provider Demographics
NPI:1689095150
Name:TRUONG, NANCY (DDS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
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 1:2800 KIRBY DR
Mailing Address - Street 2:B613
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1273
Mailing Address - Country:US
Mailing Address - Phone:917-675-2354
Mailing Address - Fax:
Practice Address - Street 1:11020 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77037-1112
Practice Address - Country:US
Practice Address - Phone:281-272-1959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-30
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056997-11223G0001X
TX301681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice