Dental Board of California
Licensing details for: 20473
Name: Jurupa Valley Dental Group, Jurupa Valley Dental Group, Inc.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
6348 Mission Blvd., Unit 105
JURUPA VALLEY CA 92509
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: LA, CASEY
License/Registration Type: Dentist License
License Number: 109006 Primary Status: Current - Active
Address :
6348 Mission Blvd
106
JURUPA VALLEY CA 92509
RIVERSIDE 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: AWAD, PAUL YOUSSEF
License/Registration Type: Dentist License
License Number: 60197 Primary Status: Current - Active
Address :
2071 RANCHO VALLEY DR. STE 140
POMONA CA 91766
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
