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Licensing details for: 59583

Name: THAKKER, JAYINI SUMAN

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

13650 Marina Pointe Dr
Unit 409
MARINA DEL REY CA 90292-9285
LOS ANGELES county
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Practice Location

18372 Clark St
224
TARZANA CA 91356-3508
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5555 Truxtun Ave
BAKERSFIELD CA 93309-7450
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Issuance Date

July 27, 2010

Expiration Date

September 30, 2026

Current Date / Time

June 6, 2025
3:1:20 PM

License Relationships

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: THAKKER, JAYINI SUMAN

License/Registration Type: General Anesthesia Permit

License Number: 1668 Primary Status: Current - Active

Address :
18372 Clark St
224
TARZANA CA 91356-3508

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