Dental Board of California
Licensing details for: 58092
Name: CHANDRA, HEENA JAI
License Type: Dentist
Primary Status: Current - Active
Previous Names: CHANDRA, HEENA J
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COSTA MESA ORAL SURGERY DENTAL PRACTICE OF LEE D. PHAM, DDS, MD, INC. AND HEENA CHANDRA, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 16528 Primary Status: Current - Active
Address :
2900 BRISTOL STREET SUITE D101
COSTA MESA CA 92626
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ALAMITOS ORAL SURGERY, DENTAL OFFICE OF DRS. POYOUROW, CHANDRA, A
License/Registration Type: Fictitious Name Permit
License Number: 11127 Primary Status: Expired
Address :
4582 KATELLA AVENUE
LOS ALAMITOS CA 90720
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: COSTA MESA ORAL SURGERY DENTAL PRACTICE OF LEE D. PHAM, DDS, MD, INC. AND HEENA CHANDRA, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 16528 Primary Status: Current - Active
Address :
2900 BRISTOL STREET SUITE D101
COSTA MESA CA 92626
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: ALAMITOS ORAL SURGERY, DENTAL OFFICE OF DRS. POYOUROW, CHANDRA, A
License/Registration Type: Fictitious Name Permit
License Number: 11127 Primary Status: Expired
Address :
4582 KATELLA AVENUE
LOS ALAMITOS CA 90720
ORANGE 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: CHANDRA, HEENA JAI
License/Registration Type: General Anesthesia Permit
License Number: 1682 Primary Status: Current - Active
Address :
4582 KATELLA AVENUE
LOS ALAMITOS CA 90720
ORANGE COUNTY
