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Licensing details for: 13610

Name: MY KID'S DENTIST DENTAL GROUP, PANGILINAN AND GILL DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

3332 N TEXAS ST STE 5D
FAIRFIELD CA 94533
SOLANO county
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Practice Location

3332 N TEXAS ST STE 5D
FAIRFIELD CA 94533
SOLANO county
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Issuance Date

June 30, 2017

Expiration Date

January 31, 2025

Current Date / Time

November 2, 2025
3:29:39 PM

License Relationships

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: PANGILINAN, JOYCE AREVALO

License/Registration Type: Dentist License

License Number: 58610 Primary Status: Current - Active

Address :
3332 N Texas St Ste C
FAIRFIELD CA 94533-9806
SOLANO 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: GILL, AMARDEEP KAUR

License/Registration Type: Dentist License

License Number: 50464 Primary Status: Current - Active

Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO 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: VICUNA, SERGIO

License/Registration Type: Dentist License

License Number: 53129 Primary Status: Current - Active

Address :
5004 S Land Park Dr
SACRAMENTO CA 95822-2504
SACRAMENTO 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: LAMBRIDIS, DEAN

License/Registration Type: Dentist License

License Number: 51199 Primary Status: Current - Active

Address :
30831 MARSEILLE WAY
WESTLAKE VILLAGE CA 91362
VENTURA COUNTY

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