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Licensing details for: 64558

Name: LIN, KUANYU

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

2288 Daniels St
MANTECA CA 95337-6706
SAN JOAQUIN county
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Issuance Date

June 17, 2015

Expiration Date

November 30, 2026

Current Date / Time

June 6, 2025
11:1:34 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: NAKAKI AND LIN DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 81027 Primary Status: Current - Active

Address :
2290 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN 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: NAKAKI AND LIN DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 81144 Primary Status: Current - Active

Address :
2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: MY KIDS DENTIST DENTAL GROUP, LIN, PHAM AND NAKAKI DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 19141 Primary Status: Current - Active

Address :
2290 DANIELS STREET
MANTECA CA 95337

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: STADIUM DENTAL GROUP, LIN, PHAM AND NAKAKI DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 19109 Primary Status: Current - Active

Address :
2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: STADIUM DENTAL GROUP, NAKAKI AND LIN DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 16749 Primary Status: Cancelled

Address :
2290 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: STADIUM DENTAL GROUP, NAKAKI AND LIN DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 17057 Primary Status: Cancelled

Address :
2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN 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: STADIUM DENTAL GROUP, LIN, PHAM AND NAKAKI DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 19109 Primary Status: Current - Active

Address :
2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN 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: MY KIDS DENTIST DENTAL GROUP, LIN, PHAM AND NAKAKI DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 19141 Primary Status: Current - Active

Address :
2290 DANIELS STREET
MANTECA CA 95337

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: STADIUM DENTAL GROUP, NAKAKI AND LIN DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 16749 Primary Status: Cancelled

Address :
2290 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN 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: STADIUM DENTAL GROUP, NAKAKI AND LIN DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 17057 Primary Status: Cancelled

Address :
2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN COUNTY

Map

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