Dental Board of California
Licensing details for: 14058
Name: TRIANGLE DENTAL GROUP, LENG AND JEFFERSON DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: JEFFERSON, WALTER
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: COMPEAN, CARLOS GUILLERMO
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: WATANABE, BRYAN KAZUMI
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LENG, NATHANIEL WEN-WEI
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: 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
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: WATANABE, BRYAN KAZUMI
License/Registration Type: Dentist License
License Number: 40130 Primary Status: Current - Active
Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE 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: LENG, NATHANIEL WEN-WEI
License/Registration Type: Dentist License
License Number: 61763 Primary Status: Current - Active
Address :
34880 Yucaipa Blvd
YUCAIPA CA 92399-4235
SAN BERNARDINO 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: COMPEAN, CARLOS GUILLERMO
License/Registration Type: Dentist License
License Number: 29127 Primary Status: Current - Active
Address :
10945South St. Ste. 200A
CERRITOS CA 90703
LOS ANGELES COUNTY
