Dental Board of California
Licensing details for: 62669
Name: TRAN, ALEXANDER SAM
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: TRAN AND LEE DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80964 Primary Status: Current - Active
Address :
42505 WASHINGTON STREET SUITE 101
PALM DESERT CA 92211
RIVERSIDE 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: DEWENTER DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81673 Primary Status: Current - Active
Address :
67760 E. PALM CANYON DRIVE
CATHEDRAL CITY CA 92234
RIVERSIDE 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: ALEXANDER TRAN DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81409 Primary Status: Current - Active
Address :
82151 AVENUE 42., SUITE 110
INDIO CA 92203
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PALM CANYON SMILES DENTISTRY DENTAL GROUP, DEWENTER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17996 Primary Status: Current - Active
Address :
67760 E. PALM CANYON DRIVE
CATHEDRAL CITY CA 92234
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: INDIO MODERN DENTISTRY DENTAL GROUP ALEXANDER TRAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14411 Primary Status: Cancelled
Address :
82151 AVENUE 42, STE 110
INDIO CA 92203
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PALM DESERT MODERN DENTISTRY DENTAL GROUP, TRAN AND LEE DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16617 Primary Status: Current - Active
Address :
42505 WASHINGTON STREET SUITE 101
PALM DESERT CA 92211
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: INDIO MODERN DENTISTRY DENTAL GROUP, ALEXANDER TRAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17619 Primary Status: Current - Active
Address :
82151 AVENUE 42., SUITE 110
INDIO CA 92203
RIVERSIDE 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: PALM CANYON SMILES DENTISTRY DENTAL GROUP, DEWENTER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17996 Primary Status: Current - Active
Address :
67760 E. PALM CANYON DRIVE
CATHEDRAL CITY CA 92234
RIVERSIDE 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: INDIO MODERN DENTISTRY DENTAL GROUP, ALEXANDER TRAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17619 Primary Status: Current - Active
Address :
82151 AVENUE 42., SUITE 110
INDIO CA 92203
RIVERSIDE 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: INDIO MODERN DENTISTRY DENTAL GROUP ALEXANDER TRAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14411 Primary Status: Cancelled
Address :
82151 AVENUE 42, STE 110
INDIO CA 92203
RIVERSIDE 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: PALM DESERT MODERN DENTISTRY DENTAL GROUP, TRAN AND LEE DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16617 Primary Status: Current - Active
Address :
42505 WASHINGTON STREET SUITE 101
PALM DESERT CA 92211
RIVERSIDE COUNTY
