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General NPI Number Information
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NPI Number | 1477969400
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Entity Type | Individual
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Provider Name | THANHNGA THI TRUONG
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Gender | Female
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 01/07/2023
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Provider Practice Location Address
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Address Line | 15355 BROOKHURST ST STE 101
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City | WESTMINSTER
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State | CA
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Zip | 92683-7071
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Country | US
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Telephone | 714-486-2958
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Fax | 714-486-2639
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Provider Business Mailing Address
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Address Line | 15355 BROOKHURST ST STE 101
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City | WESTMINSTER
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State | CA
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Zip | 92683-7071
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Country | US
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Telephone | 718-930-9981
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30283
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 63989
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License Number State | CA
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