Individual provider Active NPI

Hoan-Vu Truong, DMD

  • General Practice Dentistry
  • Fontana, CA
National Provider Identifier
1811004740
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48502 Issued in CA
Practice address
15290 Summit Ave
Suite D
Fontana, CA 92336-1009
Phone
(909) 899-8811
Fax
(909) 899-8891
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 48502 CA Primary

Addresses

Primary practice location

15290 Summit Ave
Suite D
Fontana, CA 92336-1009

Mailing address

15290 Summit Ave
Suite D
Fontana, CA 92336-1009
Phone (909) 899-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
48502CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1811004740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15290 SUMMIT AVE",
            "address_2": "SUITE D",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361009",
            "telephone_number": "909-899-8811",
            "fax_number": "909-899-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15290 SUMMIT AVE",
            "address_2": "SUITE D",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361009",
            "telephone_number": "909-899-8811",
            "fax_number": "909-899-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "HOAN-VU",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.