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Licensing details for: 79446

Name: SHETTY DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

17188 E COLIMA RD STE B
HACIENDA HEIGHTS CA 91745
LOS ANGELES county
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Practice Location

17188 E COLIMA RD STE B
HACIENDA HEIGHTS CA 91745
LOS ANGELES county
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Issuance Date

September 25, 2017

Expiration Date

November 30, 2026

Current Date / Time

June 6, 2025
2:25:21 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: SHETTY, SWATI

License/Registration Type: Dentist License

License Number: 50587 Primary Status: Current - Active

Address :
17160 Colima Rd Ste C
HACIENDA HEIGHTS CA 91745-6785
LOS ANGELES 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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE 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: CHOKKA, SUDHAKAR RAO

License/Registration Type: Dentist License

License Number: 41376 Primary Status: Current - Active

Address :
27949 Greenspot Rd
Ste. H
HIGHLAND CA 92346-4443
SAN BERNARDINO 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: NOSTI, JOHN CHARLES

License/Registration Type: Dentist License

License Number: 48655 Primary Status: Current - Active

Address :
709 Center Dr Ste 101
SAN MARCOS CA 92069-2502
SAN DIEGO COUNTY

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