Dental Board of California
Licensing details for: 106044
Name: RIVERA, REYNALDO DAVID
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by Credential
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHANNEL ISLANDS ORAL & MAXILLOFACIAL SURGERY JESSE LANZON, DDS, MD, REYNALDO RIVERA, DDS, MD, FACS DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 17046 Primary Status: Expired
Address :
4043 MISSION OAKS BLVD
CAMARILLO CA 93012
VENTURA COUNTY
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: CHANNEL ISLANDS ORAL & MAXILLOFACIAL SURGERY JESSE LANZON, DDS, MD, REYNALDO RIVERA, DDS, MD, FACS DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 17046 Primary Status: Expired
Address :
4043 MISSION OAKS BLVD
CAMARILLO CA 93012
VENTURA COUNTY
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: CHANNEL ISLANDS ORAL & MAXILLOFACIAL SURGERY JESSE LANZON, DDS,MD REYNALDO RIVERA, DDS, MD, FACS DENTATL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 17073 Primary Status: Current - Active
Address :
67 S GLENN DR
CAMARILLO CA 93010
VENTURA COUNTY
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: RIVERA, REYNALDO DAVID
License/Registration Type: General Anesthesia Permit
License Number: 2072 Primary Status: Current - Active
Address :
1111 E. OCEAN AVE, STE 9
LOMPOC CA 93436
SANTA BARBARA COUNTY
