Provider Demographics
NPI:1740155902
Name:TRUONG, NGUYEN T (DDS)
Entity type:Individual
Prefix:DR
First Name:NGUYEN
Middle Name:T
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 1:208 STIBBS CROSS RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-0069
Mailing Address - Country:US
Mailing Address - Phone:704-526-5494
Mailing Address - Fax:
Practice Address - Street 1:136 ROCKY RIVER RD # A
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-7779
Practice Address - Country:US
Practice Address - Phone:704-230-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC144891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice