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Licensing details for: 80512

Name: KEDIA AND WATANABE DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

29655 THE OLD ROAD
CASTAIC CA 91384
LOS ANGELES county
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Practice Location

29655 THE OLD ROAD
CASTAIC CA 91384
LOS ANGELES county
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Issuance Date

February 13, 2020

Expiration Date

December 31, 2026

Current Date / Time

June 6, 2025
2:19:55 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: Kedia, Rupali

License/Registration Type: Dentist License

License Number: 61648 Primary Status: Current - Active

Address :
29114 N. West Hills Drive
VALENCIA CA 91354
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: 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: 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: 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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