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Licensing details for: 101077

Name: COPPELSON, KEVIN BEHRANG

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

10921 Wilshire Blvd
Suite 912
LOS ANGELES CA 90024-3906
LOS ANGELES county
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Practice Location

27901 La Paz Rd
Ste D,
LAGUNA NIGUEL CA 92677-3932
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2801 Townsgate Rd
#120
WESTLAKE VILLAGE CA 91361-3003
VENTURA county
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3033 Bristol St
Ste 103
COSTA MESA CA 92626-3001
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9055 Woodman Ave
ARLETA CA 91331-6404
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Issuance Date

December 7, 2016

Expiration Date

December 31, 2026

Current Date / Time

December 13, 2025
7:56:40 AM

License Relationships

FNP to DDS or OMS

License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Related Party Role: Fictitious Name Permit

Name: DIAMOND BRIGHT DENTAL GROUP COPPELSON DIRECTOR DENTAL PARTNERSHIP

License/Registration Type: Fictitious Name Permit

License Number: 19074 Primary Status: Current - Active

Address :
9055 WOODMAN AVE
ARLETA CA 91331
LOS ANGELES COUNTY

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GA to DDS or OMS or SP

License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Related Party Role: General Anesthesia Permit

Name: COPPELSON, KEVIN BEHRANG

License/Registration Type: General Anesthesia Permit

License Number: 1960 Primary Status: Current - Active

Address :
10921 WILSHIRE BLVD, STE. 912
LOS ANGELES CA 90024
LOS ANGELES COUNTY

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Registered Dental Hygienist Alternative Practice to Dentist

License/Registration Role: Dentist

Related Party Role: Registered Dental Hygienist Alternative Practice

Name: VALCU-PINKERTON, SANDA

License/Registration Type: Registered Dental Hygienist Alternative Practice

License Number: 305 Primary Status: Current - Active

Address Not Disclosed

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