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Licensing details for: 81164

Name: TREVOR J. THOMAS, D.D.S., INC.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

12050 VENTURA BLVD., SUITE C-101
STUDIO CITY CA 91604
LOS ANGELES county
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Practice Location

12050 VENTURA BLVD., SUITE C-101
STUDIO CITY CA 91604
LOS ANGELES county
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Issuance Date

March 8, 2022

Expiration Date

April 30, 2026

Current Date / Time

September 9, 2025
5:25:9 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: THOMAS, TREVOR JAMAL

License/Registration Type: Dentist License

License Number: 100514 Primary Status: Current - Active

Address :
11980 San Vicente Blvd
Ste. 507
LOS ANGELES CA 90049-5012
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: HANNA, JOSEPH

License/Registration Type: Dentist License

License Number: 62486 Primary Status: Current - Active

Address :
10316 mason ave
CHATSWORTH CA 91311
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: 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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