Dental Board of California
Licensing details for: 52
Name: JACKS, SCOTT THOMAS
License Type: Oral Conscious Sedation
Primary Status: Deceased
Specialty: Minor
Previous Names: JACKS, SCOTT
Address of Record
4444 TWEEDY BLVD
SOUTH GATE CA 90280
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 5154 Primary Status: Cancelled
Address :
2144 S. BRISTOL ST.
SANTA ANA CA 92704
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PARK PLAZA CHILDREN'S DENTISTRY AND ORTHODONTICS, DENTAL OFFICE O
License/Registration Type: Fictitious Name Permit
License Number: 11594 Primary Status: Cancelled
Address :
4138 N MAINE AVE STE M-2
BALDWIN PARK CA 91706
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS INC.
License/Registration Type: Fictitious Name Permit
License Number: 9334 Primary Status: Cancelled
Address :
897 W. EL CAMINO REAL
SUNNYVALE CA 94087
SANTA CLARA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7229 Primary Status: Cancelled
Address :
14119 PIONEER BLVD.
NORWALK CA 90650
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 5156 Primary Status: Cancelled
Address :
2156 E. LINCOLN
ANAHEIM CA 92806
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 732 Primary Status: Cancelled
Address :
SCOTT JACKS DDS INC
4444 TWEEDY BLVD
SOUTH GATE CA 90292
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP, SCOTT JACKS, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 7409 Primary Status: Cancelled
Address :
1153 KING ROAD
STE. B
SAN JOSE CA 95122
SANTA CLARA COUNTY
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: JACKS, SCOTT THOMAS
License/Registration Type: Dentist License
License Number: 24464 Primary Status: Deceased
Address :
28 CENTERPOINTE DR
LA PALMA CA 90623
ORANGE COUNTY
