Dental Board of California
Licensing details for: 23941
Name: NISHINO, PHILIP KATSUMI
License Type: Dentist
Primary Status: Current - Active
Secondary Status: Radiation Safety Certification issued by the Board
Address of Record
104 Sunhaven Rd
DANVILLE CA 94506-1901
CONTRA COSTA county
Map
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP KATSUMI NISHINO DDS
License/Registration Type: Additional Office Permit
License Number: 4604 Primary Status: Cancelled
Address :
1511 SYCAMORE AVENUE
SUITE A
HERCULES CA 94547
CONTRA COSTA COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP KATSUMI NISHINO DDS
License/Registration Type: Additional Office Permit
License Number: 4603 Primary Status: Cancelled
Address :
39489 FREMONT BLVD
FREMONT CA 94538
ALAMEDA COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP K NISHINO, DDS
License/Registration Type: Additional Office Permit
License Number: 5586 Primary Status: Cancelled
Address :
1710 EAST MARCH LANE
STOCKTON CA 95210
SAN JOAQUIN COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP K. NISHINO, DDS
License/Registration Type: Additional Office Permit
License Number: 5585 Primary Status: Cancelled
Address :
2930 ABORN SQUARE
SAN JOSE CA 95121
SANTA CLARA COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP KATSUMI NISHINO DDS
License/Registration Type: Additional Office Permit
License Number: 5332 Primary Status: Cancelled
Address :
2225 PLAZA PARKWAY
SUITE P 1
MODESTO CA 95350
STANISLAUS COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP KATSUMI NISHINO DDS
License/Registration Type: Additional Office Permit
License Number: 4605 Primary Status: Cancelled
Address :
1160 ARNOLD DRIVE
MARTINEZ CA 94553
CONTRA COSTA COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP KATSUMI NISHINO DDS
License/Registration Type: Additional Office Permit
License Number: 5333 Primary Status: Cancelled
Address :
591 WATT AVENUE
SACRAMENTO CA 95864
SACRAMENTO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHILIP K. NISHINO, DDS, INC
License/Registration Type: Additional Office Permit
License Number: 7285 Primary Status: Cancelled
Address :
2135 TRACY BLVD
TRACY CA 95376
SAN JOAQUIN COUNTY
