Healthcare Provider Details

I. General information

NPI: 1336678572
Provider Name (Legal Business Name): LONG NGOC TRUONG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2017
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9373 BARINGER FOREMAN RD STE 101
BATON ROUGE LA
70817-6200
US

IV. Provider business mailing address

9373 BARINGER FOREMAN RD STE 101
BATON ROUGE LA
70817-6200
US

V. Phone/Fax

Practice location:
  • Phone: 225-339-9129
  • Fax:
Mailing address:
  • Phone: 225-339-9129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6766
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: