Dental Board of California
Licensing details for: 20225
Name: Azusa Modern Dentistry, Dental Group of Azusa Modern Dentistry, Inc.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
806 N Azusa Ave
AZUSA CA 91702
Map
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: MEKHAEL, YOUSTINA ALBER
License/Registration Type: Dentist License
License Number: 105261 Primary Status: Current - Active
Address :
806 N Azusa Ave
AZUSA CA 91702-2509
LOS ANGELES 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: CAMACHO, CLAUDIA
License/Registration Type: Dentist License
License Number: 103989 Primary Status: Current - Active
Address :
892 W Beverly Blvd
MONTEBELLO CA 90640-4213
LOS ANGELES 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: CHOKKA, SUDHAKAR RAO
License/Registration Type: Dentist License
License Number: 41376 Primary Status: Current - Active
Address :
27949 Greenspot Rd
Ste. H
HIGHLAND CA 92346-4443
SAN BERNARDINO 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: ZAKLAMA, KARIM MAGID
License/Registration Type: Dentist License
License Number: 61349 Primary Status: Current - Active
Address :
2700 E Workman Ave
WEST COVINA CA 91791-6625
LOS ANGELES 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: LENG, NATHANIEL WEN-WEI
License/Registration Type: Dentist License
License Number: 61763 Primary Status: Current - Active
Address :
34880 Yucaipa Blvd
YUCAIPA CA 92399-4235
SAN BERNARDINO COUNTY
