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Licensing details for: 13810

Name: CHILDREN'S DENTISTRY AND ORTHODONTICS OF BAKERSFIELD, A DENTAL OFFICE OF STEVE O'HARA DDS, JORDAN PRIETO DDS, JEFFREY EVANS DDS AND JEFFREY KUNKEL DDS

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Secondary Status: Cancelled at the Request of the LicenseePrimary Status Definition

Address of Record

3807 SAN DIMAS ST STE C
BAKERSFIELD CA 93301
KERN county
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Practice Location

3807 SAN DIMAS ST STE C
BAKERSFIELD CA 93301
KERN county
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Issuance Date

October 4, 2017

Expiration Date

April 30, 2019

Current Date / Time

June 6, 2025
9:56:2 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KUNKEL, JEFF RALPH

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: EVANS, JEFFREY BAIRD

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PRIETO, JORDAN DAVID

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: O'HARA, STEPHEN DONALD

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: O'HARA, STEPHEN DONALD

License/Registration Type: Dentist License

License Number: 46666 Primary Status: Current - Active

Address :
7770 N Fresno St Ste 101
FRESNO CA 93720-2412
FRESNO 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: PRIETO, JORDAN DAVID

License/Registration Type: Dentist License

License Number: 61309 Primary Status: Current - Active

Address :
1900 Shaw Ave
101
CLOVIS CA 93611-4208
FRESNO 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: KUNKEL, JEFF RALPH

License/Registration Type: Dentist License

License Number: 60083 Primary Status: Current - Active

Address :
7525 N Cedar Ave Ste 105
FRESNO CA 93720-2698
FRESNO 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: EVANS, JEFFREY BAIRD

License/Registration Type: Dentist License

License Number: 59512 Primary Status: Current - Active

Address :
7525 N. CEDAR AVE
SUITE 105
FRESNO CA 93720
FRESNO COUNTY

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