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Licensing details for: 79439

Name: JEDEDIAH V. HUSS, D.D.S., INC

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

5784 LINDERO CANYON RD STE B
THOUSAND OAKS CA 91362
VENTURA county
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Practice Location

5784 LINDERO CANYON RD STE B
THOUSAND OAKS CA 91362
VENTURA county
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Issuance Date

September 11, 2017

Expiration Date

May 31, 2019

Current Date / Time

June 6, 2025
2:25:8 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: WATANABE, LYNDA CAROL

License/Registration Type: Dentist License

License Number: 40116 Primary Status: Current - Active

Address :
8715 Trautwein Rd
RIVERSIDE CA 92508-9474
RIVERSIDE COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: HUYNH, PHI CANH

License/Registration Type: Dentist License

License Number: 56413 Primary Status: Current - Active

Address :
11700 Heliotrope Ct
BAKERSFIELD CA 93311-8751
KERN COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: HUSS, JEDEDIAH VAL

License/Registration Type: Dentist License

License Number: 60491 Primary Status: Current - Active

Address :
806 New Los Angeles Ave
Suite B
MOORPARK CA 93021-3585
VENTURA COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: JEFFERSON, WALTER

License/Registration Type: Dentist License

License Number: 53460 Primary Status: Current - Active

Address :
16475 SIERRA LAKES PKWY
STE 140
FONTANA CA 92336
SAN BERNARDINO COUNTY

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