Dental Board of California
Licensing details for: 61270
Name: LORENZ, BROCK JASON
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
6622 Cedarwood Dr
HUNTINGTON BEACH CA 92648-6658
ORANGE county
Map
License Relationships
CS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Conscious Sedation Permit
Name: LORENZ, BROCK JASON
License/Registration Type: Conscious Sedation Permit
License Number: 863 Primary Status: Cancelled
Address :
15720 Ventura Blvd
Unit 322
ENCINO CA 91436-2914
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: GOLDEN COAST DENTAL CARE: DENTAL PRACTICE OF BROCK LORENZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17556 Primary Status: Current - Active
Address :
5963 E. SPRING STREET
LONG BEACH CA 90808
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SPRING DENTAL GROUP: BROCK LORENZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17553 Primary Status: Expired
Address :
5963 E. SPRING STREET
LONG BEACH CA 90808
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SHERMAN OAKS SMILES DENTAL OFFICE OF DRS. KIMIA, LORENZ, AND POULDAR
License/Registration Type: Fictitious Name Permit
License Number: 17530 Primary Status: Expired
Address :
14912 BURBANK BLVD
SHERMAN OAKS CA 91411
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ENCINO FAMILY DENTAL GROUP, OFFICE OF KIMIA & LORENZ DENTAL PARTNERSHIP
License/Registration Type: Fictitious Name Permit
License Number: 13118 Primary Status: Expired
Address :
14912 Burbank Blvd
SHERMAN OAKS CA 91411-3609
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: SHERMAN OAKS SMILES DENTAL OFFICE OF DRS. KIMIA, LORENZ, AND POULDAR
License/Registration Type: Fictitious Name Permit
License Number: 17530 Primary Status: Expired
Address :
14912 BURBANK BLVD
SHERMAN OAKS CA 91411
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: SPRING DENTAL GROUP: BROCK LORENZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17553 Primary Status: Expired
Address :
5963 E. SPRING STREET
LONG BEACH CA 90808
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: ENCINO FAMILY DENTAL GROUP, OFFICE OF KIMIA & LORENZ DENTAL PARTNERSHIP
License/Registration Type: Fictitious Name Permit
License Number: 13118 Primary Status: Expired
Address :
14912 Burbank Blvd
SHERMAN OAKS CA 91411-3609
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: GOLDEN COAST DENTAL CARE: DENTAL PRACTICE OF BROCK LORENZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17556 Primary Status: Current - Active
Address :
5963 E. SPRING STREET
LONG BEACH CA 90808
LOS ANGELES COUNTY
MS 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: Moderate Sedation Permit
Name: LORENZ, BROCK JASON
License/Registration Type: Moderate Sedation Permit
License Number: 441 Primary Status: Current - Active
Address :
5963 E. SPRING STREET
LONG BEACH CA 90808
LOS ANGELES COUNTY
