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Licensing details for: 20223

Name: The Dental Office of Lakewood

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

2710 Carson Street
LAKEWOOD CA 90712
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Issuance Date

February 3, 2026

Expiration Date

February 29, 2028

Current Date / Time

April 4, 2026
4:40:36 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: OATES, CHRISTOPHER COLLINS

License/Registration Type: Dentist License

License Number: 58874 Primary Status: Current - Active

Address :
1559 Pacific Coast Hwy
Ste 101
HERMOSA BEACH CA 90254-3214
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: JEFFERSON, WALTER

License/Registration Type: Dentist License

License Number: 53460 Primary Status: Current - Active

Address :
16475 SIERRA LAKES PKWY
STE 140
FONTANA CA 92336
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: NGUYEN, BACH XUAN

License/Registration Type: Dentist License

License Number: 49784 Primary Status: Current - Active

Address :
13528 Lakewood Blv
BELLFLOWER CA 90706

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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: LEONG, JESSICA LIM

License/Registration Type: Dentist License

License Number: 100389 Primary Status: Current - Active

Address :
2710 E. Carson St.
LAKEWOOD CA 90712
LOS ANGELES COUNTY

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