Provider Demographics
NPI:1235937897
Name:TRUONG, ANH THI QUYNH
Entity type:Individual
Prefix:
First Name:ANH
Middle Name:THI QUYNH
Last Name:TRUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 AUDREY LN
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1301
Mailing Address - Country:US
Mailing Address - Phone:301-567-5437
Mailing Address - Fax:
Practice Address - Street 1:30 AUDREY LN
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1301
Practice Address - Country:US
Practice Address - Phone:301-567-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401419555122300000X
DCDEN2001572122300000X
VA390200000X
MD18927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program