Provider Demographics
NPI:1144107467
Name:TRUONG, THERESA CHU (DDS)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:CHU
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 1:8216 MONTEVINA DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-1705
Mailing Address - Country:US
Mailing Address - Phone:916-595-7615
Mailing Address - Fax:
Practice Address - Street 1:8876 VINTAGE PARK DR STE 105
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-5894
Practice Address - Country:US
Practice Address - Phone:916-595-7615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1120251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice