Provider Demographics
NPI:1033239983
Name:TRUONG, THUY GIA (DDS)
Entity Type:Individual
Prefix:
First Name:THUY
Middle Name:GIA
Last Name:TRUONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 MERIDIAN AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2905
Mailing Address - Country:US
Mailing Address - Phone:408-295-2394
Mailing Address - Fax:408-295-4560
Practice Address - Street 1:259 MERIDIAN AVE STE 18
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2905
Practice Address - Country:US
Practice Address - Phone:408-295-2394
Practice Address - Fax:408-295-4560
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0382341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice