Dental Board of California
Licensing details for: 524
Name: PENUMETCHA, SIREESHA
License Type: Moderate Sedation Permit
Primary Status: Current - Active
Address of Record
4720 ELK GROVE BLVD STE 170
DR SIREESHA PENUMETCHA
ELK GROVE CA 95758-4185
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LAKEPOINT DENTAL, PRACTICE OF SIREESHA PENUMETCHA, DDS, PC.
License/Registration Type: Fictitious Name Permit
License Number: 9159 Primary Status: Current - Active
Address :
4720 ELK GROVE BOULEVARD
STE. 170
ELK GROVE CA 95758
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LAKEPOINT DENTAL PRACTICE OF DR. SIREESHA PENUMETCHA
License/Registration Type: Fictitious Name Permit
License Number: 6317 Primary Status: Cancelled
Address :
4720 ELK GROVE BLVD
ELK GROVE CA 95758
SACRAMENTO COUNTY
MS to DDS or OMS or SP
License/Registration Role: Moderate Sedation Permit
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: PENUMETCHA, SIREESHA
License/Registration Type: Dentist License
License Number: 49635 Primary Status: Current - Active
Address :
4720 Elk Grove Blvd
Suite #170
ELK GROVE CA 95758-4183
SACRAMENTO COUNTY
