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Licensing details for: 1491

Name: CAPUTO, JEFFREY MARSHALL

License Type: Dentist General Anesthesia

Primary Status: Current - Active

Address of Record

26302 LA PAZ ROAD #102
MISSION VIEJO CA 92691
ORANGE county
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Issuance Date

June 22, 2009

Expiration Date

September 30, 2026

Current Date / Time

June 7, 2025
6:54:16 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: ORANGE COUNTY CENTERS FOR ORAL SURGERY AND DENTAL IMPLANTS CUMMINGS, BALASANIAN, CAPUTO & NICHOLLS DENTAL GROUP INC.

License/Registration Type: Fictitious Name Permit

License Number: 13021 Primary Status: Expired

Address :
1171 PUERTA DEL SOL, #D
SAN CLEMENTE CA 92673
ORANGE COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: ORANGE COUNTY CENTERS FOR ORAL SURGERY AND DENTAL IMPLANTS CUMMINGS, BALASANIAN, CAPUTO & NICHOLLS DENTAL GROUP INC.

License/Registration Type: Fictitious Name Permit

License Number: 13020 Primary Status: Expired

Address :
360 SAN MIGUEL, #402
NEWPORT BEACH CA 92660
ORANGE COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: ORANGE COUNTY CENTERS FOR ORAL SURGERY AND DENTAL IMPLANTS CUMMINGS, BALASANIAN, CAPUTO & NICHOLLS DENTAL GROUP INC.

License/Registration Type: Fictitious Name Permit

License Number: 12962 Primary Status: Expired

Address :
26302 LA PAZ ROAD, #102
MISSION VIEJO CA 92691
ORANGE COUNTY

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GA to DDS or OMS or SP

License/Registration Role: General Anesthesia Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: CAPUTO, JEFFREY MARSHALL

License/Registration Type: Dentist License

License Number: 55550 Primary Status: Current - Active

Address :
26302 LA PAZ RD
STE. 102
MISSION VIEJO CA 92691
ORANGE COUNTY

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