Dental Board of California
Licensing details for: 103905
Name: SU, KEVIN JING-YUAN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: Kevin Su Dental Corporation
License/Registration Type: Fictitious Name Permit
License Number: 16924 Primary Status: Current - Active
Address :
8561 Irvine Center Drive
IRVINE CA 92618
ORANGE COUNTY
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: LOS OLIVOS DENTISTRY DENTAL GROUP, KEVIN SU DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16924 Primary Status: Current - Active
Address :
8561 Irvine Center Drive
IRVINE CA 92618
ORANGE COUNTY
