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Licensing details for: 12189

Name: BRILLIANT SMILES FAMILY DENTAL CARE DENTAL OFFICE OF KARL G. LUM

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: BRILLIANT SMILES FAMILY DENTAL CARE

Address of Record

39572 STEVENSON PLACE, SUITE 223
FREMONT CA 94539
ALAMEDA county
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Issuance Date

June 2, 2015

Expiration Date

March 31, 2026

Current Date / Time

June 6, 2025
2:11:3 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LUM, KARL GUT JR

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LUM, ROBERT MARK

Address Not Disclosed

FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: LUM, KARL GUT JR

License/Registration Type: Dentist License

License Number: 39984 Primary Status: Current - Active

Address :
39572 Stevenson Pl
SUITE 223
FREMONT CA 94539-3075
ALAMEDA COUNTY

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FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: LUM, ROBERT MARK

License/Registration Type: Dentist License

License Number: 43812 Primary Status: Current - Active

Address :
1399 S Winchester Blvd
130
SAN JOSE CA 95128-4300
SANTA CLARA COUNTY

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