Provider Demographics
NPI:1396152948
Name:TRUONG, KHANH DUY (DMD, MSD)
Entity type:Individual
Prefix:
First Name:KHANH
Middle Name:DUY
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 HILLCROFT ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1014
Mailing Address - Country:US
Mailing Address - Phone:832-831-2368
Mailing Address - Fax:
Practice Address - Street 1:6001 HILLCROFT ST
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1014
Practice Address - Country:US
Practice Address - Phone:832-831-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302991223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry