Dental Board of California
Licensing details for: 80504
Name: JACKSON DENTAL CORPORATION
License Type: Additional Office Permit
Primary Status: Cancelled
Organization Classification: Corporation
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: SAMBANGI, MANORANJANI
License/Registration Type: Dentist License
License Number: 50520 Primary Status: Current - Active
Address :
CHINO HILLS DENTAL GROUP
3410 GRAND AVE
CHINO HILLS CA 91709
SAN BERNARDINO COUNTY
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: JACKSON, TANISHA ANJANETTE
License/Registration Type: Dentist License
License Number: 47103 Primary Status: Current - Active
Address :
422 Orange St
REDLANDS CA 92374-3206
SAN BERNARDINO COUNTY
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
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
