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Licensing details for: 15669

Name: DELTA SHORES DENTISTRY DENTAL GROUP DANG AND GILL DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

8204 DELTA SHORES CIRCLE S., SUITE 140
SACRAMENTO CA 95832
SACRAMENTO county
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Practice Location

8204 DELTA SHORES CIRCLE S., SUITE 140
SACRAMENTO CA 95832
SACRAMENTO county
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Issuance Date

February 11, 2020

Expiration Date

April 30, 2025

Current Date / Time

June 6, 2025
2:15:32 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LOPEZ, MICHAEL JAMES

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BAUTISTA, REYMOND CARBONELL

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: DANG, AVALPREET SINGH

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GILL, AMARDEEP KAUR

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: 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: LOPEZ, MICHAEL JAMES

License/Registration Type: Dentist License

License Number: 57591 Primary Status: Current - Active

Address :
1556 Aria Ct
LIVERMORE CA 94550-6077
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: DANG, AVALPREET SINGH

License/Registration Type: Dentist License

License Number: 102629 Primary Status: Current - Active

Address :
3630 G St
Ste C
MERCED CA 95340-9201
MERCED 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: BAUTISTA, REYMOND CARBONELL

License/Registration Type: Dentist License

License Number: 56217 Primary Status: Current - Active

Address :
1221 Albright Walk
SACRAMENTO CA 95818-1682
SACRAMENTO COUNTY

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