Dental Board of California
Licensing details for: 17659
Name: ELK GROVE DENTAL GROUP - MY KIDS DENTIST, INAKSH JOHAL DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PATEL, DHAVAL RAMAN
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: GILL, AMARDEEP KAUR
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: JOHAL, INAKSH
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
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: JOHAL, INAKSH
License/Registration Type: Dentist License
License Number: 50475 Primary Status: Current - Active
Address :
9640 Bruceville Rd Ste 101
ELK GROVE CA 95757-5937
SACRAMENTO COUNTY
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: PATEL, DHAVAL RAMAN
License/Registration Type: Dentist License
License Number: 54297 Primary Status: Current - Active
Address :
10357 Fairway Dr
Ste 100
ROSEVILLE CA 95678-3544
PLACER COUNTY
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
