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Licensing details for: 20222

Name: Vacaville Dentistry, Dental Group of Vacaville Dentistry, Inc.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

671 Elmira Rd, Ste 130
VACAVILLE CA 95687
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Issuance Date

February 3, 2026

Expiration Date

February 29, 2028

Current Date / Time

April 4, 2026
2:55:49 AM

License Relationships

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: MANTENA, USHA RASHMI

License/Registration Type: Dentist License

License Number: 46110 Primary Status: Current - Active

Address :
671 Elmira Rd # 130
VACAVILLE CA 95687-4655

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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: 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

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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: MOKBIL, AHMAD

License/Registration Type: Dentist License

License Number: 101058 Primary Status: Current - Active

Address :
1016 Riley St
1
1016 Riley St
FOLSOM CA 95630-3265

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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: 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

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