Dental Board of California
Licensing details for: 25165
Name: LEVY, THOMAS ALLEN
License Type: Dentist
Primary Status: Current - Active
Secondary Status: Reduced Renewal Fee
Address of Record
4405 N Country Club Ln
LONG BEACH CA 90807-1430
LOS ANGELES 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: THOMAS A. LEVY, DDS
License/Registration Type: Additional Office Permit
License Number: 7409 Primary Status: Cancelled
Address :
1816 W KETTLEMAN SUITE C
LODI CA 95240
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: THOMAS ALLEN LEVY, DDS
License/Registration Type: Additional Office Permit
License Number: 7097 Primary Status: Cancelled
Address :
1816 W. KETTLEMAN, SUITE C
LODI CA 95240
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: THOMAS A LEVY DDS
License/Registration Type: Additional Office Permit
License Number: 4893 Primary Status: Cancelled
Address :
1217 W. TOKAY
LODI CA 94240
SAN JOAQUIN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DELTA ENDODONTICS LEVY STEFANAC DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 913 Primary Status: Cancelled
Address :
4661 PRECISSI LANE
STOCKTON CA 95207
SAN JOAQUIN 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: DELTA ENDODONTICS LEVY STEFANAC DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 913 Primary Status: Cancelled
Address :
4661 PRECISSI LANE
STOCKTON CA 95207
SAN JOAQUIN 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: LEVY, THOMAS ALLEN
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 2385 Primary Status: Cancelled
Address :
15 CALYPSO ST
ALISO VIEJO CA 92656
ORANGE COUNTY
