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Licensing details for: 17107

Name: DENTISTS OF PASADENA ON LAKE DENTAL GROUP, MARTIN GALSTYAN, D.D.S., INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

240 S. LAKE AVENUE
PASADENA CA 91101
LOS ANGELES county
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Practice Location

240 S. LAKE AVENUE
PASADENA CA 91101
LOS ANGELES county
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Issuance Date

April 27, 2022

Expiration Date

May 31, 2027

Current Date / Time

June 6, 2025
9:21:3 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GALSTYAN, MARTIN ARAMIS

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LENG, NATHANIEL WEN-WEI

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHOKKA, SUDHAKAR RAO

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ZAKLAMA, KARIM MAGID

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: CHOKKA, SUDHAKAR RAO

License/Registration Type: Dentist License

License Number: 41376 Primary Status: Current - Active

Address :
27949 Greenspot Rd
Ste. H
HIGHLAND CA 92346-4443
SAN BERNARDINO 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: GALSTYAN, MARTIN ARAMIS

License/Registration Type: Dentist License

License Number: 61923 Primary Status: Current - Active

Address :
PO BOX 909
GLENDALE CA 91209
LOS ANGELES 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: ZAKLAMA, KARIM MAGID

License/Registration Type: Dentist License

License Number: 61349 Primary Status: Current - Active

Address :
2700 E Workman Ave
WEST COVINA CA 91791-6625
LOS ANGELES 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: 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

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