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Licensing details for: 4416

Name: OH, JASON JAESONG

License Type: Oral Conscious Sedation

Primary Status: Current - Active

Specialty: Adult

Address of Record

520 West Palmdale Blvd.
Suite O
PALMDALE CA 93551
LOS ANGELES county
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Issuance Date

December 1, 2023

Expiration Date

August 31, 2025

Current Date / Time

June 6, 2025
8:30:31 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: A.V. SIERRA DENTAL CENTER, JASON OH, D.D.S., INC

License/Registration Type: Fictitious Name Permit

License Number: 7021 Primary Status: Cancelled

Address :
38427 N. 20TH STREET E
PALMDALE CA 93550
LOS ANGELES COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: PALMDALE DENTAL ARTS, DENTAL PRACTICE OF JASON OH DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 13705 Primary Status: Cancelled

Address :
38427 20TH ST EAST
PALMDALE CA 93550
LOS ANGELES COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: AV SIERRA DENTAL CENTER, DENTAL PRACTICE OF JASON OH DDS INC

License/Registration Type: Fictitious Name Permit

License Number: 13861 Primary Status: Cancelled

Address :
38427 20TH ST EAST
PALMDALE CA 93550
LOS ANGELES COUNTY

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OCS to DDS, OMS, or SP

License/Registration Role: Oral Conscious Sedation Certificate

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

Name: OH, JASON JAESONG

License/Registration Type: Dentist License

License Number: 53091 Primary Status: Current - Active

Address :
520 West Palmdale Blvd.
Suite O
PALMDALE CA 93551
LOS ANGELES COUNTY

Map

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