Dental Board of California
Licensing details for: 53248
Name: NAKANO, JONATHAN KIYOMI
License Type: Dentist
Primary Status: Current - Active
Address of Record
61 Long Ct Ste 101
THOUSAND OAKS CA 91360-6083
VENTURA county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ANTELOPE VALLEY DENTAL SURGERY CENTER DENTAL GROUP OF SNOW, NAKANO & LOPEZ PROFESSIONAL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15280 Primary Status: Current - Active
Address :
868 AUTO CENTER DRIVE SUITE A
PALMDALE CA 93551
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: ANTELOPE VALLEY DENTAL SURGERY CENTER DENTAL GROUP OF SNOW, NAKANO & LOPEZ PROFESSIONAL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15280 Primary Status: Current - Active
Address :
868 AUTO CENTER DRIVE SUITE A
PALMDALE CA 93551
LOS ANGELES COUNTY
GA to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: General Anesthesia Permit
Name: NAKANO, JONATHAN KIYOMI
License/Registration Type: General Anesthesia Permit
License Number: 1413 Primary Status: Current - Active
Address :
61 Long Ct
Suite 101
THOUSAND OAKS CA 91360-6048
VENTURA COUNTY
