Dental Board of California
Licensing details for: 61931
Name: JEONG, DONG JUN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
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: MELANIE KIM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80658 Primary Status: Current - Active
Address :
3381 BASS LAKE ROAD, SUITE 140
EL DORADO HILLS CA 95762
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: CASTILLO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81566 Primary Status: Current - Active
Address :
10842 BEAR HOLLOW DRIVE SUITE 101
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: DENTAL CORPORATION OF JASON LEE
License/Registration Type: Additional Office Permit
License Number: 81412 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: 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: DONG JEONG, DDS
License/Registration Type: Additional Office Permit
License Number: 82187 Primary Status: Current - Active
Address :
5925 BIRDCAGE CENTRE LANE SUITE D105
CITRUS HEIGHTS CA 95610
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: Current - Active
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: DENTAL CORPORATION OF JASON LEE
License/Registration Type: Additional Office Permit
License Number: 81564 Primary Status: Current - Active
Address :
8854 MADISON AVE
FAIR OAKS CA 95628
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
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: Current - Active
Address :
10910 OLSON DRIVE. SUITE 100
RANCHO CORDOVA CA 95670
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MATHER MODERN DENTISTRY DENTAL GROUP, CASTILLO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17950 Primary Status: Current - Active
Address :
10842 BEAR HOLLOW DRIVE SUITE 101
RANCHO CORDOVA CA 95670
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
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: Current - Active
Address :
5925 BIRDCAGE CENTRE LANE, SUITE D105
CITRUS HEIGHTS CA 95610
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: RIVER CITY DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17617 Primary Status: Cancelled
Address :
8908 MADISON AVENUE
FAIR OAKS CA 95628
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF EL DORADO HILLS DENTAL GROUP, MELANIE KIM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15971 Primary Status: Current - Active
Address :
3381 BASS LAKE ROAD, SUITE 140
EL DORADO HILLS CA 95762
EL DORADO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF FAIR OAKS DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17936 Primary Status: Expired
Address :
8854 Madison Avenue
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: DENTISTS OF FAIR OAKS DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17936 Primary Status: Expired
Address :
8854 Madison Avenue
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: CITRUS HEIGHTS MODERN DENTISTRY DENTAL GROUP, MOHINI PATEL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17694 Primary Status: Current - Active
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: RIVER CITY DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17617 Primary Status: Cancelled
Address :
8908 MADISON AVENUE
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: MATHER MODERN DENTISTRY DENTAL GROUP, CASTILLO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17950 Primary Status: Current - Active
Address :
10842 BEAR HOLLOW DRIVE SUITE 101
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: RANCHO CORDOVA DENTAL GROUP JEONG DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16587 Primary Status: Current - Active
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: DENTISTS OF EL DORADO HILLS DENTAL GROUP, MELANIE KIM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15971 Primary Status: Current - Active
Address :
3381 BASS LAKE ROAD, SUITE 140
EL DORADO HILLS CA 95762
EL DORADO COUNTY
