Provider Demographics
NPI:1346413747
Name:TRUONG, HOA VU (DMD)
Entity Type:Individual
Prefix:DR
First Name:HOA
Middle Name:VU
Last Name:TRUONG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:HOA
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:27131 ALISO CREEK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3361
Mailing Address - Country:US
Mailing Address - Phone:949-362-3668
Mailing Address - Fax:949-362-4683
Practice Address - Street 1:27131 ALISO CREEK RD STE 120
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3361
Practice Address - Country:US
Practice Address - Phone:949-362-3668
Practice Address - Fax:949-362-4683
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473311223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1609069731Medicaid