Provider Demographics
NPI:1013940915
Name:TRUONG, NHAN TRONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:NHAN
Middle Name:TRONG
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BEN
Other - Middle Name:NHAN
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3960 W CRAIG RD STE 110
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2750
Mailing Address - Country:US
Mailing Address - Phone:702-464-3000
Mailing Address - Fax:702-386-0360
Practice Address - Street 1:3960 W CRAIG RD STE 110
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2750
Practice Address - Country:US
Practice Address - Phone:702-464-3000
Practice Address - Fax:702-386-0360
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3691122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1013940915Medicaid
NV002202152Medicaid