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Licensing details for: 103379

Name: DHAMOTHARAN KUMAR, MAWNA

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

12111 Alcosta Blvd
SAN RAMON CA 94583-2637
CONTRA COSTA county
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Practice Location

12111 Alcosta Blvd
SAN RAMON CA 94583-2637
CONTRA COSTA county
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Issuance Date

November 19, 2018

Expiration Date

September 30, 2026

Current Date / Time

June 7, 2025
2:40:25 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: Mawna Dhamotharan Kumar DDS Inc

License/Registration Type: Fictitious Name Permit

License Number: 17906 Primary Status: Current - Active

Address :
12111 ALCOSTA BLVD
SAN RAMON CA 94583
CONTRA COSTA COUNTY

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FNP to DDS or OMS

License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Related Party Role: Fictitious Name Permit

Name: DK DENTAL CARE DENTAL PRACTICE OF DR. KUMAR

License/Registration Type: Fictitious Name Permit

License Number: 17906 Primary Status: Current - Active

Address :
12111 ALCOSTA BLVD
SAN RAMON CA 94583
CONTRA COSTA COUNTY

Map

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