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: KENNETH K. CHAN, DDS
License/Registration Type: Additional Office Permit
License Number: 10210 Primary Status: Expired
Address :
15260 FAIRGROVE AVE.
LA PUENTE CA 91744
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: KENNETH K. CHAN, DDS
License/Registration Type: Additional Office Permit
License Number: 9677 Primary Status: Expired
Address :
1315 FAIR OAKS AVE.
#103
SOUTH PASADENA CA 91030
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HEALTHY SMILE FAMILY DENTISTRY, DENTAL OFFICE OF
License/Registration Type: Fictitious Name Permit
License Number: 4870 Primary Status: Current - Active
Address :
1315 FAIR OAKS AVE, STE 103
SOUTH PASADENA CA 91030
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SAN GABRIEL DENTAL GROUP, CHAN & CHAN, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7472 Primary Status: Expired
Address :
6909 N. ROSEMEAD BLVD.
SAN GABRIEL CA 91775
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HUNTINGTON ORTHODONTICS AND DENTAL SPECIALTIES DENTAL PRACTICE OF DRS. CHAN, CHAN, CHENG AND LEE
License/Registration Type: Fictitious Name Permit
License Number: 18283 Primary Status: Current - Active
Address :
1041 W HUNTINGTON DR
ARCADIA CA 91007-6536
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: SAN GABRIEL DENTAL GROUP, CHAN & CHAN, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7472 Primary Status: Expired
Address :
6909 N. ROSEMEAD BLVD.
SAN GABRIEL CA 91775
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: HUNTINGTON ORTHODONTICS AND DENTAL SPECIALTIES DENTAL PRACTICE OF DRS. CHAN, CHAN, CHENG AND LEE
License/Registration Type: Fictitious Name Permit
License Number: 18283 Primary Status: Current - Active
Address :
1041 W HUNTINGTON DR
ARCADIA CA 91007-6536
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: HEALTHY SMILE FAMILY DENTISTRY, DENTAL OFFICE OF
License/Registration Type: Fictitious Name Permit
License Number: 4870 Primary Status: Current - Active
Address :
1315 FAIR OAKS AVE, STE 103
SOUTH PASADENA CA 91030
LOS ANGELES COUNTY
