Dental Board of California
Licensing details for: 46830
Name: IBRAHIM, ESSAM AHMED
License Type: Dentist
Primary Status: Current - Active
Address of Record
5301 LOCHMOOR DR
RIVERSIDE CA 92507
RIVERSIDE county
Map
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: HAITHAM ELGENDI DENTAL CORP.
License/Registration Type: Additional Office Permit
License Number: 8938 Primary Status: Cancelled
Address :
2585 W. FLORIDA AVE.
HEMET CA 92545
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: KIRBY AND FLORIDA DENTAL GROUP, HAITHAM ELGENDI DENTAL
License/Registration Type: Fictitious Name Permit
License Number: 5393 Primary Status: Cancelled
Address :
2585 W FLORIDA AVE
HEMET CA 92545
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: KIRBY AND FLORIDA DENTAL GROUP, IBRAHIM, HASHEM & SALEM DENTAL CO
License/Registration Type: Fictitious Name Permit
License Number: 11736 Primary Status: Current - Active
Address :
2585 W FLORIDA AVENUE
HEMET CA 92545
RIVERSIDE 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: KIRBY AND FLORIDA DENTAL GROUP, IBRAHIM, HASHEM & SALEM DENTAL CO
License/Registration Type: Fictitious Name Permit
License Number: 11736 Primary Status: Current - Active
Address :
2585 W FLORIDA AVENUE
HEMET CA 92545
RIVERSIDE 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: KIRBY AND FLORIDA DENTAL GROUP, HAITHAM ELGENDI DENTAL
License/Registration Type: Fictitious Name Permit
License Number: 5393 Primary Status: Cancelled
Address :
2585 W FLORIDA AVE
HEMET CA 92545
RIVERSIDE COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: IBRAHIM, ESSAM AHMED
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 4473 Primary Status: Current - Active
Address :
2585 W Florida Ave
HEMET CA 92545-4615
