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Licensing details for: 17620

Name: PACIFIC DENTAL GROUP, LYNDA WATANABE DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

31754 TEMECULA PARKWAY., SUITE E
TEMECULA CA 92592
RIVERSIDE county
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Practice Location

31754 TEMECULA PARKWAY., SUITE E
TEMECULA CA 92592
RIVERSIDE county
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Issuance Date

January 20, 2023

Expiration Date

September 30, 2026

Current Date / Time

June 6, 2025
1:53:50 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHU, FRANKLIN TEH-SUN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ABRAMS, ASHLEY LEANN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NOSTI, JOHN CHARLES

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: DHAMA, DEEPIKA S

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WATANABE, LYNDA CAROL

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: ABRAMS, ASHLEY LEANN

License/Registration Type: Dentist License

License Number: 63062 Primary Status: Current - Active

Address :
27339 DARLENE DRIVE
MORENO VALLEY CA 92555
RIVERSIDE 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: WATANABE, LYNDA CAROL

License/Registration Type: Dentist License

License Number: 40116 Primary Status: Current - Active

Address :
8715 Trautwein Rd
RIVERSIDE CA 92508-9474
RIVERSIDE 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: DHAMA, DEEPIKA S

License/Registration Type: Dentist License

License Number: 49044 Primary Status: Current - Active

Address :
2044 California Ave
CORONA CA 92881-3300
RIVERSIDE 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: CHU, FRANKLIN TEH-SUN

License/Registration Type: Dentist License

License Number: 61692 Primary Status: Current - Active

Address :
31843 Rancho California Rd
STE 300
TEMECULA CA 92591-5120
RIVERSIDE 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: NOSTI, JOHN CHARLES

License/Registration Type: Dentist License

License Number: 48655 Primary Status: Current - Active

Address :
709 Center Dr Ste 101
SAN MARCOS CA 92069-2502
SAN DIEGO COUNTY

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