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Licensing details for: 80508

Name: OKTANYAN DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

2220 FOOTHILL BLVD, SUITE A
LA CANADA FLINTRIDGE CA 91011
LOS ANGELES county
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Practice Location

2220 FOOTHILL BLVD, SUITE A
LA CANADA FLINTRIDGE CA 91011
LOS ANGELES county
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Issuance Date

February 13, 2020

Expiration Date

July 31, 2025

Current Date / Time

June 6, 2025
2:28:54 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: 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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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, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
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: 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: OKTANYAN, HAMBIK

License/Registration Type: Dentist License

License Number: 52096 Primary Status: Current - Active

Address :
2220 Foothill Blvd Ste A
LA CANADA FLINTRIDGE CA 91011-1413
LOS ANGELES COUNTY

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