Healthcare Provider Details
I. General information
NPI: 1962349456
Provider Name (Legal Business Name): BRIAN T. LUONG DMD MBA MS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5753 E SANTA ANA CANYON RD STE K
ANAHEIM CA
92807-3230
US
IV. Provider business mailing address
5753 E SANTA ANA CANYON RD STE K
ANAHEIM CA
92807-3230
US
V. Phone/Fax
- Phone: 714-998-4700
- Fax:
- Phone: 714-998-4700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
LUONG
Title or Position: OWNER
Credential: DMD
Phone: 714-366-2032