Healthcare Provider Details

I. General information

NPI: 1023620150
Provider Name (Legal Business Name): DUY THIEN VINH TRUONG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

IV. Provider business mailing address

7305 CORD GRASS LN
BEAUFORT SC
29906-6105
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-5600
  • Fax:
Mailing address:
  • Phone: 714-548-2867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number105544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: