Dental Board of California
Licensing details for: 24464
Name: JACKS, SCOTT THOMAS
License Type: Dentist
Primary Status: Deceased
Previous Names: JACKS, SCOTT
Address of Record
28 CENTERPOINTE DR
LA PALMA CA 90623
ORANGE 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: SCOTT JACKS, D.D.S., INC.
License/Registration Type: Additional Office Permit
License Number: 11540 Primary Status: Cancelled
Address :
4138 N. MAINE AVE STE M-2
BALDWIN PARK CA 91706
LOS ANGELES 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: SCOTT JACKS, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 9357 Primary Status: Cancelled
Address :
4354 TWEEDY BLVD.
SOUTH GATE CA 90280
LOS ANGELES 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: SCOTT JACKS, DDS, INC
License/Registration Type: Additional Office Permit
License Number: 8352 Primary Status: Cancelled
Address :
2156 E LINCOLN AVE
ANAHEIM CA 92806
ORANGE 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: SCOTT JACKS, DDS, INC
License/Registration Type: Additional Office Permit
License Number: 7214 Primary Status: Cancelled
Address :
14119 PIONEER BLVD
NORWALK CA 90650
LOS ANGELES 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: SCOTT JACKS, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 9608 Primary Status: Cancelled
Address :
1153 E. KING ROAD
STE. B
SAN JOSE CA 95122
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: SCOTT JACKS, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 10453 Primary Status: Cancelled
Address :
897 W. EL CAMINO REAL
SUNNYVALE CA 94087
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: SCOTT JACKS, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 9358 Primary Status: Cancelled
Address :
20700 AVALON BLVD.
STE. 600
CARSON CA 90746
LOS ANGELES 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: SCOTT JACKS, DDS, INC
License/Registration Type: Additional Office Permit
License Number: 8353 Primary Status: Cancelled
Address :
2144 S BRISTOL ST
SANTA ANA CA 92704
ORANGE 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: SCOTT T JACKS, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 9355 Primary Status: Cancelled
Address :
2700 COLORADO BLVD.
STE. 263
LOS ANGELES CA 90041
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 732 Primary Status: Cancelled
Address :
SCOTT JACKS DDS INC
4444 TWEEDY BLVD
SOUTH GATE CA 90292
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7409 Primary Status: Cancelled
Address :
1153 KING ROAD
STE. B
SAN JOSE CA 95122
SANTA CLARA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7229 Primary Status: Cancelled
Address :
14119 PIONEER BLVD.
NORWALK CA 90650
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 5154 Primary Status: Cancelled
Address :
2144 S. BRISTOL ST.
SANTA ANA CA 92704
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 5156 Primary Status: Cancelled
Address :
2156 E. LINCOLN
ANAHEIM CA 92806
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PARK PLAZA CHILDREN'S DENTISTRY AND ORTHODONTICS, DENTAL OFFICE O
License/Registration Type: Fictitious Name Permit
License Number: 11594 Primary Status: Cancelled
Address :
4138 N MAINE AVE STE M-2
BALDWIN PARK CA 91706
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS INC.
License/Registration Type: Fictitious Name Permit
License Number: 9334 Primary Status: Cancelled
Address :
897 W. EL CAMINO REAL
SUNNYVALE CA 94087
SANTA CLARA 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: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 5154 Primary Status: Cancelled
Address :
2144 S. BRISTOL ST.
SANTA ANA CA 92704
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: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS INC.
License/Registration Type: Fictitious Name Permit
License Number: 9334 Primary Status: Cancelled
Address :
897 W. EL CAMINO REAL
SUNNYVALE CA 94087
SANTA CLARA 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: PARK PLAZA CHILDREN'S DENTISTRY AND ORTHODONTICS, DENTAL OFFICE O
License/Registration Type: Fictitious Name Permit
License Number: 11594 Primary Status: Cancelled
Address :
4138 N MAINE AVE STE M-2
BALDWIN PARK CA 91706
LOS ANGELES 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: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 5156 Primary Status: Cancelled
Address :
2156 E. LINCOLN
ANAHEIM CA 92806
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: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7229 Primary Status: Cancelled
Address :
14119 PIONEER BLVD.
NORWALK CA 90650
LOS ANGELES 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: CHILDREN'S DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 732 Primary Status: Cancelled
Address :
SCOTT JACKS DDS INC
4444 TWEEDY BLVD
SOUTH GATE CA 90292
LOS ANGELES 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: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7409 Primary Status: Cancelled
Address :
1153 KING ROAD
STE. B
SAN JOSE CA 95122
SANTA CLARA COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: JACKS, SCOTT THOMAS
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 52 Primary Status: Deceased
Address :
4444 TWEEDY BLVD
SOUTH GATE CA 90280
LOS ANGELES COUNTY
