Dental Board of California
Licensing details for: 1337
Name: EVERGREEN DENTAL GROUP
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Partnership
Previous Names: EVERGREEN DENTAL GROUP, MICHAEL T. VEHAWN
Address of Record
MICHAEL T. VEHAWN
3162 NEWBERRY DRIVE
SAN JOSE CA 95118
SANTA CLARA county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: TAKLA, PAUL MICHAEL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BAJAJ, SUNITA
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: VEHAWN, MICHAEL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: VEHAWN, MICHAEL T
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: TAKLA, PAUL M
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: VEHAWN, MICHAEL T
License/Registration Type: Dentist License
License Number: 26717 Primary Status: Expired
Address :
2732 LUCENA DRIVE
SAN JOSE CA 95132
SANTA CLARA COUNTY
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: TAKLA, PAUL MICHAEL
License/Registration Type: Dentist License
License Number: 38465 Primary Status: Current - Active
Address :
2130 RALSTON AVE STE 1E
BELMONT CA 94002
SAN MATEO COUNTY
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: BAJAJ, SUNITA
License/Registration Type: Dentist License
License Number: 42118 Primary Status: Current - Inactive
Address :
10235 Byrne Ave
CUPERTINO CA 95014-2809
SANTA CLARA COUNTY
