Dual MD-DDS credentials — a Hahnemann University (now Drexel University College of Medicine) Doctor of Medicine earned in 1989 plus 1992 board certification in oral and maxillofacial surgery — credential Machado Lester DDS at the 501 Washington Street Scripps Mercy Hospital medical office complex in Hillcrest 92103. Orthognathic cases requiring multi-year bracket or aligner coordination partner with Milberg Orthodontics for the presurgical and postsurgical alignment phases of corrective jaw work. IV sedation, wisdom tooth extraction, dental implant placement, bone grafting, and All-on-4 full-arch implant arches make up the in-office surgical menu, with bilingual English-Spanish chairside communication available. Implant abutment cases needing fixed-bridge or removable overdenture restorations refer the prosthetic phase to New Smile Prosthodontics Dental office for the final tooth fabrication. Cysts of the jaw and pre-prosthetic alveolar reconstruction add the deepest pathology cases to the chairside surgical schedule. Double-jaw orthognathic surgery — Le Fort I maxillary osteotomy paired with bilateral sagittal split mandibular osteotomy for severe skeletal malocclusion — represents the highest-complexity reconstruction performed at the Hillcrest suite.