Provider Demographics
NPI:1013803030
Name:TRUONG, NGUYEN CHRISTINE THUY VAN (DDS)
Entity type:Individual
Prefix:
First Name:NGUYEN CHRISTINE THUY VAN
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-6137
Mailing Address - Country:US
Mailing Address - Phone:704-492-5847
Mailing Address - Fax:
Practice Address - Street 1:1512 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:WELLSBURG
Practice Address - State:WV
Practice Address - Zip Code:26070-1323
Practice Address - Country:US
Practice Address - Phone:304-737-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4785122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist