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Licensing details for: 17616

Name: TUSTIN LEGACY DENTISTRY DENTAL GROUP, VANSON DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

15160 KENSINGTON PARK DRIVE SUITE 610
TUSTIN CA 92782
ORANGE county
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Practice Location

15160 KENSINGTON PARK DRIVE SUITE 610
TUSTIN CA 92782
ORANGE county
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Issuance Date

January 20, 2023

Expiration Date

July 31, 2026

Current Date / Time

June 6, 2025
9:49:22 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KANSAGRA, BINDU B

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PANDHOH, SUMEET SWAROOP

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SHETTY, SWATI

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: VANSON, LINDA MYLINH

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: PANDHOH, SUMEET SWAROOP

License/Registration Type: Dentist License

License Number: 51507 Primary Status: Expired

Address :
45 Auto Center Dr
Suite 110
FOOTHILL RANCH CA 92610-2848
ORANGE 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: SHETTY, SWATI

License/Registration Type: Dentist License

License Number: 50587 Primary Status: Current - Active

Address :
17160 Colima Rd Ste C
HACIENDA HEIGHTS CA 91745-6785
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: VANSON, LINDA MYLINH

License/Registration Type: Dentist License

License Number: 47576 Primary Status: Current - Active

Address :
15160 Kensington Park Dr
610
TUSTIN CA 92782-1825
ORANGE 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: KANSAGRA, BINDU B

License/Registration Type: Dentist License

License Number: 57691 Primary Status: Current - Active

Address :
14415 Culver Dr
IRVINE CA 92604-0305
ORANGE COUNTY

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