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Licensing details for: 17459

Name: HIGH DESERT SMILES DENTISTRY DENTAL GROUP, RITESH KUMAR DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

12821 MAIN STREET., SUITE 150
HESPERIA CA 92345
SAN BERNARDINO county
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Practice Location

12821 MAIN STREET., SUITE 150
HESPERIA CA 92345
SAN BERNARDINO county
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Issuance Date

October 28, 2022

Expiration Date

October 31, 2026

Current Date / Time

June 6, 2025
2:6:20 AM

License Relationships

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 Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KUMAR, RITESH

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: 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: 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: KUMAR, RITESH

License/Registration Type: Dentist License

License Number: 50944 Primary Status: Current - Active

Address :
2468 San Antonio Cres E
UPLAND CA 91784-1180
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: 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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