Dental Board of California
Licensing details for: 57591
Name: LOPEZ, MICHAEL JAMES
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
1556 Aria Ct
LIVERMORE CA 94550-6077
ALAMEDA 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: DHAVAL PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79267 Primary Status: Expired
Address :
3000 DANVILLE BLVD STE A
ALAMO CA 94507
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: WADHWA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80305 Primary Status: Current - Active
Address :
2503 BELL ROAD
AUBURN CA 95603
PLACER 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: MANNEM AND GHAZAL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79978 Primary Status: Current - Active
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: GILL, BAUTISTA AND LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79563 Primary Status: Cancelled
Address :
8204 DELTA SHORES CIR S STE 140
SACRAMENTO CA 95832
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: AMARDEEP GILL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79874 Primary Status: Cancelled
Address :
2041 BRONZE STAR DR STE 100
WOODLAND CA 95776
YOLO 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: POLUMBO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79690 Primary Status: Cancelled
Address :
3291 STANFORD RANCH ROAD, STE 102
ROCKLIN CA 95765
PLACER 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: SHEYNIE VO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79580 Primary Status: Expired
Address :
3967 MISSOURI FLAT RD STE 120
PLACERVILLE CA 95667
EL DORADO 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: LOPEZ AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80514 Primary Status: Cancelled
Address :
4375 1ST STREET
LIVERMORE CA 94551
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: MOKBIL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81282 Primary Status: Current - Active
Address :
4022 SUNRISE BLVD SUITE 160
RANCHO CORDOVA CA 95742
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: SOOD AND FAREID DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81455 Primary Status: Cancelled
Address :
1193 E. CHAMPLAIN DRIVE
FRESNO CA 93720
FRESNO 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: MICHAEL LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 78893 Primary Status: Cancelled
Address :
2103 MCHENRY AVENUE
SUITE C
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: DELGADO AND O'DONNELL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79984 Primary Status: Cancelled
Address :
8908 MADISON AVENUE
FAIR OAKS CA 95628
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: STOUT DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80732 Primary Status: Cancelled
Address :
3967 MISSOURI FLAT ROAD, SUITE 120
PLACERVILLE CA 95667
EL DORADO 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: ENTABI AND FAREID DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80956 Primary Status: Cancelled
Address :
2682 NAGLEE RD STE 110
TRACY CA 95304
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: MANPREET KAUR DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80978 Primary Status: Current - Active
Address :
6623 N. RIVERSIDE DRIVE, SUITE 101
FRESNO CA 93722
FRESNO 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: TULLY AND MOKBIL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81066 Primary Status: Cancelled
Address :
2228 FAIR OAKS BLVD
SACRAMENTO CA 95825
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: LOPEZ AND LAMBRIDIS DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 11510 Primary Status: Cancelled
Address :
4375 1ST STREET
LIVERMORE CA 94551
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: GILL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79365 Primary Status: Cancelled
Address :
2503 BELL ROAD
AUBURN CA 95603
PLACER 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: ISAAC NAVARRO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79373 Primary Status: Cancelled
Address :
3206 N DINUBA BLVD., SUITE F
VISALIA CA 93291
TULARE 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: MOHINI PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81445 Primary Status: Cancelled
Address :
5925 BIRDCAGE CENTRE LANE, SUITE D105
CITRUS HEIGHTS CA 95610
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: KAILA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79422 Primary Status: Cancelled
Address :
5925 BIRDCAGE CENTRE LANE STE D105
CITRUS HEIGHTS CA 95610
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: LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79691 Primary Status: Cancelled
Address :
3601 PELANDALE AVE, STE D1
MODESTO CA 95356
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: BAUTISTA AND LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79526 Primary Status: Expired
Address :
10910 OLSON DR STE 100
RANCHO CORDOVA CA 95670
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: JEONG DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80954 Primary Status: Cancelled
Address :
10910 OLSON DRIVE. SUITE 100
RANCHO CORDOVA CA 95670
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: GILL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79258 Primary Status: Cancelled
Address :
3967 MISSOURI FLAT RD STE 120
PLACERVILLE CA 95667
EL DORADO 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: KESHTKAR DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79367 Primary Status: Expired
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: ISAAC NAVARRO AND BEVAN FAREID DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79821 Primary Status: Expired
Address :
2682 NAGLEE ROAD, STE 110
TRACY CA 95304
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: GILL AND LOPEZ PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80358 Primary Status: Cancelled
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: GHAZAL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79475 Primary Status: Cancelled
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: BAUTISTA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79476 Primary Status: Cancelled
Address :
4022 SUNRISE BLVD STE 160
RANCHO CORDOVA CA 95742
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: NAVARRO AND MELARA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80860 Primary Status: Cancelled
Address :
3206 N. DINUBA BLVD., SUITE F
VISALIA CA 93291
TULARE 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: GILL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81147 Primary Status: Cancelled
Address :
110 NUT TREE PARKWAY
VACAVILLE CA 95687
SOLANO 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: PARULEKAR DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81529 Primary Status: Current - Active
Address :
3746 Fallon Road
DUBLIN CA 94568
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: GILL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80359 Primary Status: Expired
Address :
110 NUT TREE PARKWAY
VACAVILLE CA 95687
SOLANO 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: MOKBIL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80511 Primary Status: Cancelled
Address :
4022 SUNRISE BLVD., SUITE 160
RANCHO CORDOVA CA 95742
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: SALVADOR MELARA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81271 Primary Status: Current - Active
Address :
3206 N. DINUBA BLVD., SUITE F
VISALIA CA 93291
TULARE 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: ATOARDOSHAHI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80882 Primary Status: Expired
Address :
3601 PELANDALE AVENUE SUITE D-1
MODESTO CA 95356
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: KHALED ENTABI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80859 Primary Status: Expired
Address :
3746 FALLON ROAD
DUBLIN CA 94568
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: KHALED ENTABI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81342 Primary Status: Expired
Address :
3746 FALLON ROAD
DUBLIN CA 94568
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: FAREID AND NAVARRO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79693 Primary Status: Cancelled
Address :
1193 E. CHAMPLAIN DRIVE
FRESNO CA 93720
FRESNO 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: CAROLYN GHAZAL AND MICHAEL LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79535 Primary Status: Cancelled
Address :
6623 N RIVERSIDE DR STE 101
FRESNO CA 93722
FRESNO 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: CALICDAN AND GILL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80689 Primary Status: Cancelled
Address :
241 W. EAST AVENUE, SUITE 1
CHICO CA 95926
BUTTE 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: BEVAN S. FAREID, D.D.S., INC.
License/Registration Type: Additional Office Permit
License Number: 81194 Primary Status: Current - Active
Address :
827 AKERS STREET., SUITE 104
VISALIA CA 93277
TULARE 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: MAKADIA AND STOUT DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81343 Primary Status: Current - Active
Address :
3967 MISSOURI FLAT ROAD., SUITE 120
PLACERVILLE CA 95667
EL DORADO 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: AMEZCUA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79383 Primary Status: Cancelled
Address :
3290 ARENA BLVD STE 610
SACRAMENTO CA 95834
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: SERGIO VICUNA, D.D.S., INC.
License/Registration Type: Additional Office Permit
License Number: 79179 Primary Status: Current - Active
Address :
1804 19th St
SUITE 100
SACRAMENTO CA 95811-6700
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: MIN DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80144 Primary Status: Cancelled
Address :
8211 BRUCEVILLE ROAD, SUITE 155
SACRAMENTO CA 95823
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: REYMOND BAUTISTA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80220 Primary Status: Expired
Address :
3640 CROCKER DRIVE, SUITE 130
SACRAMENTO CA 95818
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: ENTABI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80168 Primary Status: Current - Active
Address :
2600 S. TRACY BLVD., SUITE 170
TRACY CA 95376
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: ANTONO TEANG DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79477 Primary Status: Current - Active
Address :
1208 FITZGERALD DR
PINOLE CA 94564
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: SINGH AND PATEL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81153 Primary Status: Current - Active
Address :
3000 DANVILLE BLVD. SUITE A
ALAMO CA 94507
CONTRA COSTA 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: PARKWAY DENTAL GROUP, KESHTKAR DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13598 Primary Status: Cancelled
Address :
781 STERLING PKWY
LINCOLN CA 95648
PLACER 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: HIGHLAND DENTAL GROUP, JOESTING DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17631 Primary Status: Current - Active
Address :
3291 STANFORD RANCH ROAD., SUITE 102
ROCKLIN CA 95765
PLACER 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: MIDTOWN MODERN DENTAL GROUP SERGIO VICUNA, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 13205 Primary Status: Current - Active
Address :
1804 19TH STREET, STE. 100
SACRAMENTO CA 95811
SACRAMENTO 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: HIGHLAND DENTAL GROUP, POLUMBO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14250 Primary Status: Cancelled
Address :
3291 STANFORD RANCH RD STE 102
ROCKLIN CA 95765
PLACER 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: NUT TREE SMILES DENTISTRY DENTAL GROUP GILL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15446 Primary Status: Expired
Address :
110 NUT TREE PARKWAY
VACAVILLE CA 95687
SOLANO 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: CHICO MODERN DENTISTRY DENTAL GROUP, CALICDAN AND GILL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16054 Primary Status: Expired
Address :
241 W. EAST AVENUE, SUITE 1
CHICO CA 95926
BUTTE 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: ALAMO SMILES DENTAL GROUP, SINGH AND PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17058 Primary Status: Current - Active
Address :
3000 DANVILLE BLVD. SUITE A
ALAMO CA 94507
CONTRA COSTA 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: MARKET WEST DENTAL GROUP, AMEZCUA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13639 Primary Status: Current - Active
Address :
3290 ARENA BLVD STE 610
SACRAMENTO CA 95834
SACRAMENTO 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: STRAWBERRY CREEK DENTAL GROUP MIN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15096 Primary Status: Current - Active
Address :
8211 BRUCEVILLE ROAD, SUITE 155
SACRAMENTO CA 95823
SACRAMENTO 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: MISSOURI FLAT DENTAL GROUP, SHEYNIE VO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14005 Primary Status: Expired
Address :
3967 MISSOURI FLAT RD STE 120
PLACERVILLE CA 95667
EL DORADO 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: RANCHO CORDOVA DENTAL GROUP JEONG DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16587 Primary Status: Expired
Address :
10910 OLSON DRIVE. SUITE 100
RANCHO CORDOVA CA 95670
SACRAMENTO 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: CITRUS HEIGHTS MODERN DENTISTRY DENTAL GROUP, MOHINI PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17694 Primary Status: Expired
Address :
5925 BIRDCAGE CENTRE LANE, SUITE D105
CITRUS HEIGHTS CA 95610
SACRAMENTO 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: PARKWAY DENTAL GROUP GILL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15447 Primary Status: Cancelled
Address :
781 STERLING PARKWAY
LINCOLN CA 95648
PLACER 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: RIVER CITY DENTAL GROUP DELGADO AND O'DONNELL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14857 Primary Status: Expired
Address :
8908 MADISON AVE
FAIR OAKS CA 95628
SACRAMENTO 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: RANCHO CORDOVA SMILES DENTISTRY DENTAL GROUP, BAUTISTA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13756 Primary Status: Cancelled
Address :
4022 SUNRISE BLVD STE 160
RANCHO CORDOVA CA 95742
SACRAMENTO 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 WEST DENTAL GROUP, GHAZAL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13758 Primary Status: Cancelled
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: DENTISTS OF VISALIA DENTAL GROUP, BEVAN S. FAREID, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 17115 Primary Status: Current - Active
Address :
827 AKERS STREET., SUITE 104
VISALIA CA 93277
TULARE 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: RANCHO CORDOVA SMILES DENTISTRY DENTAL GROUP, MOKBIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17908 Primary Status: Current - Active
Address :
4022 SUNRISE BLVD SUITE 160
RANCHO CORDOVA CA 95742
SACRAMENTO 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: FALLON DENTAL GROUP, PARULEKAR DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17822 Primary Status: Current - Active
Address :
3746 FALLON ROAD
DUBLIN CA 94568
ALAMEDA 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: ALAMO SMILES DENTAL GROUP DHAVAL PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13407 Primary Status: Expired
Address :
3000 DANVILLE BLVD STE A
ALAMO CA 94507
CONTRA COSTA 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: MODESTO MODERN DENTISTRY DENTAL GROUP MICHAEL LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 12717 Primary Status: Cancelled
Address :
2103 MCHENRY AVENUE, SUITE C
MODESTO CA 95350
STANISLAUS 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: NUT TREE SMILES DENTISTRY DENTAL GROUP, GILL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17055 Primary Status: Expired
Address :
110 NUT TREE PARKWAY
VACAVILLE CA 95687
SOLANO 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: FALLON DENTAL GROUP, KHALED ENTABI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16440 Primary Status: Expired
Address :
3746 FALLON ROAD
DUBLIN CA 94568
ALAMEDA 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: MODESTO SMILES DENTISTRY DENTAL GROUP, LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14248 Primary Status: Cancelled
Address :
3601 PELANDALE AVE STE D-1
MODESTO CA 95356
STANISLAUS 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: LIVERMORE SMILES DENTISTRY AND ORTHODONTICS DENTAL GROUP - MY KID
License/Registration Type: Fictitious Name Permit
License Number: 11455 Primary Status: Cancelled
Address :
4375 1ST STREET
LIVERMORE CA 94551
ALAMEDA 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: MISSOURI FLAT DENTAL GROUP GILL AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13451 Primary Status: Cancelled
Address :
3967 MISSOURI FLAT RD STE 120
PLACERVILLE CA 95667
EL DORADO 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: NAGLEE DENTAL GROUP ISAAC NAVARRO AND BEVAN FAREID DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14498 Primary Status: Cancelled
Address :
2682 NAGLEE ROAD, STE 110
TRACY CA 95304
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: SIERRA SMILES DENTISTRY DENTAL GROUP WADHWA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15368 Primary Status: Current - Active
Address :
2503 BELL ROAD
AUBURN CA 95603
PLACER 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 SHORES DENTISTRY DENTAL GROUP DANG AND GILL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15669 Primary Status: Expired
Address :
8204 DELTA SHORES CIRCLE S., SUITE 140
SACRAMENTO CA 95832
SACRAMENTO 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: RANCHO CORDOVA SMILES DENTISTRY DENTAL GROUP MOKBIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15676 Primary Status: Cancelled
Address :
4022 SUNRISE BLVD., SUITE 160
RANCHO CORDOVA CA 95742
SACRAMENTO 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: DENTISTS OF CAMPUS COMMONS DENTAL GROUP, TULLY AND MOKBIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16853 Primary Status: Cancelled
Address :
2228 FAIR OAKS BLVD
SACRAMENTO CA 95825
SACRAMENTO 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: CHAMPLAIN DENTISTRY DENTAL GROUP, SOOD AND FAREID DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17689 Primary Status: Current - Active
Address :
1193 E. CHAMPLAIN DRIVE
FRESNO CA 93720
FRESNO 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: SIERRA SMILES DENTISTRY DENTAL GROUP, GILL AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13596 Primary Status: Expired
Address :
2503 BELL RD
AUBURN CA 95603
PLACER 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: VISALIA MODERN DENTISTRY DENTAL GROUP, ISAAC NAVARRO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13609 Primary Status: Cancelled
Address :
3206 N DINUBA BLVD STE F
VISALIA CA 93291
TULARE 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: MODESTO MODERN DENTISTRY DENTAL GROUP, MICHAEL LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14015 Primary Status: Expired
Address :
2103 MCHENRY AVE STE C
MODESTO CA 95350
STANISLAUS 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 WEST DENTAL GROUP MANNEM AND GHAZAL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14827 Primary Status: Current - Active
Address :
10928 TRINITY PKWY
STOCKTON CA 95219
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: WOODLAND SMILES DENTISTRY DENTAL GROUP AMARDEEP GILL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14573 Primary Status: Current - Active
Address :
2041 BRONZE STAR DR STE 100
WOODLAND CA 95776
YOLO 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: DENTISTS OF ARDEN DENTAL GROUP YUN HWAN OH DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15082 Primary Status: Current - Active
Address :
3521 ARDEN WAY, SUITE 101
SACRAMENTO CA 95864
SACRAMENTO 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 SHORES DENTISTRY DENTAL GROUP, GILL, BAUTISTA AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13954 Primary Status: Cancelled
Address :
8204 DELTA SHORES CIRCLE S. STE 140
SACRAMENTO CA 95832
SACRAMENTO 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: CHAMPLAIN DENTISTRY DENTAL GROUP, FAREID AND NAVARRO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14523 Primary Status: Cancelled
Address :
1193 E CHAMPLAIN DR
FRESNO CA 93720
FRESNO 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: RANCHO CORDOVA DENTAL GROUP, BAUTISTA AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13872 Primary Status: Cancelled
Address :
10910 OLSON DR STE 100
RANCHO CORDOVA CA 95670
SACRAMENTO 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: VISALIA MODERN DENTISTRY DENTAL GROUP, NAVARRO AND MELARA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16441 Primary Status: Expired
Address :
3206 N. DINUBA BLVD., SUITE F
VISALIA CA 93291
TULARE 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: NAGLEE DENTAL GROUP, ENTABI AND FAREID DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16562 Primary Status: Current - Active
Address :
2682 NAGLEE ROAD. SUITE 110
TRACY CA 95304
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: VISALIA MODERN DENTISTRY DENTAL GROUP, SALVADOR MELARA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17148 Primary Status: Current - Active
Address :
3206 N. DINUBA BLVD., SUITE F
VISALIA CA 93291
TULARE 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: LIVERMORE SMILES DENTISTRY DENTAL GROUP - MY KID'S DENTIST, LOPEZ AND BAUTISTA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17098 Primary Status: Current - Active
Address :
4375 1ST STREET
LIVERMORE CA 94551
ALAMEDA 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: MISSOURI FLAT DENTAL GROUP, MAKADIA AND STOUT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17455 Primary Status: Current - Active
Address :
3967 MISSOURI FLAT ROAD., SUITE 120
PLACERVILLE CA 95667
EL DORADO 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: LAND PARK MODERN DENTISTRY DENTAL GROUP REYMOND BAUTISTA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15201 Primary Status: Cancelled
Address :
3640 CROCKER DRIVE, SUITE 130
SACRAMENTO CA 95818
SACRAMENTO 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: TRACY SMILES MODERN DENTISTRY DENTAL GROUP ENTABI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15167 Primary Status: Current - Active
Address :
2600 S. TRACY BLVD., SUITE 170
TRACY CA 95376
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: PINOLE MODERN DENTISTRY DENTAL GROUP, ANTONO TEANG DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13755 Primary Status: Current - Active
Address :
1208 FITZGERALD DR
PINOLE CA 94564
CONTRA COSTA 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: MARKETPLACE SMILES DENTISTRY DENTAL GROUP, CAROLYN GHAZAL AND MICHAEL LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13903 Primary Status: Current - Active
Address :
6623 N RIVERSIDE DR STE 101
FRESNO CA 93722
FRESNO 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: MISSOURI FLAT DENTAL GROUP, STOUT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16164 Primary Status: Cancelled
Address :
3967 MISSOURI FLAT ROAD., SUITE 120
PLACERVILLE CA 95667
EL DORADO 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: MODESTO SMILES DENTISTRY DENTAL GROUP, ATOARDOSHAHI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16473 Primary Status: Expired
Address :
3601 PELANDALE AVENUE SUITE D-1
MODESTO CA 95356
STANISLAUS 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: CITRUS HEIGHTS MODERN DENTISTRY DENTAL GROUP, KAILA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13675 Primary Status: Cancelled
Address :
5925 BIRDCAGE CENTRE LN STE D105
CITRUS HEIGHTS CA 95610
SACRAMENTO COUNTY
