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Licensing details for: 62766

Name: LE, RONNY TRAN

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

1068 Vega Way
SAN MARCOS CA 92078-2819
SAN DIEGO county
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Practice Location

4142 Adams Ave
Suite 104
SAN DIEGO CA 92116-2592
SAN DIEGO county
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Issuance Date

August 5, 2013

Expiration Date

December 31, 2025

Current Date / Time

June 6, 2025
3:16:47 PM

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: LE AND PHAM DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 11633 Primary Status: Cancelled

Address :
4142 ADAMS AVENUE
SUITE 104
SAN DIEGO CA 92116
SAN DIEGO COUNTY

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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: YIGE ZHAO DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 80413 Primary Status: Current - Active

Address :
9840 CARMEL MOUNTAIN ROAD
SAN DIEGO CA 92129
SAN DIEGO COUNTY

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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: RONNY LE DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 80338 Primary Status: Cancelled

Address :
1350 E. VISTA WAY, SUITE 10
VISTA CA 92084
SAN DIEGO COUNTY

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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: LE AND PHAM DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 80177 Primary Status: Current - Active

Address :
4142 ADAMS AVENUE, SUITE 104
SAN DIEGO CA 92116
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: KENSINGTON DENTAL GROUP, LE AND PHAM DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 15140 Primary Status: Current - Active

Address :
4142 ADAMS AVENUE, SUITE 104
SAN DIEGO CA 92116
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: RANCHO PENASQUITOS DENTISTRY DENTAL GROUP YIGE ZHAO DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 15513 Primary Status: Current - Active

Address :
9840 CARMEL MOUNTAIN ROAD
SAN DIEGO CA 92129
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: VISTA MODERN DENTISTRY DENTAL GROUP RONNY LE DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 15414 Primary Status: Cancelled

Address :
1350 E. VISTA WAY., SUITE 10
VISTA CA 92084
SAN DIEGO COUNTY

Map

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: VISTA MODERN DENTISTRY DENTAL GROUP RONNY LE DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 15414 Primary Status: Cancelled

Address :
1350 E. VISTA WAY., SUITE 10
VISTA CA 92084
SAN DIEGO COUNTY

Map

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 PENASQUITOS DENTISTRY DENTAL GROUP YIGE ZHAO DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 15513 Primary Status: Current - Active

Address :
9840 CARMEL MOUNTAIN ROAD
SAN DIEGO CA 92129
SAN DIEGO COUNTY

Map

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: KENSINGTON DENTAL GROUP, LE AND PHAM DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 15140 Primary Status: Current - Active

Address :
4142 ADAMS AVENUE, SUITE 104
SAN DIEGO CA 92116
SAN DIEGO COUNTY

Map

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