Dental Board of California
Licensing details for: 51046
Name: Borrero Fonseca, Maria Camila
License Type: Dentist
Primary Status: Current - Active
Probation Summary: Description: Maria Borrero Fonseca (Respondent), DDS 51046, entered into a 5-year probationary term imposed pursuant to an adjudicated decision, effective September 18, 2016. This probationary term is anticipated to end September 17, 2021.
Below are the causes for probation:
• Respondent has been licensed to practice since 2003 with no record of discipline with the Board and she has never been sued for malpractice. Respondent acknowledged the deficiencies in her practice and has made changes to her practice. The public protection would be served by allowing respondent to maintain her license and permit on a restricted basis for 5 years.
Restrictions of Practice: Below of the terms of the Disciplinary Order, terms 1-14 are considered standard:
1. Obey All Laws
2. Quarterly Reports
3. Comply with the Board’s Probation Program
4. Address Change, Name Change, License Status
5. Meetings and Interviews
6. Status of Residency, Practice, or Licensure Outside of State
7. Submit Documentation
8. Cost Recovery $25,427.40
9. Probation Monitoring Costs
10. License Surrender
11. Function as a Licensee
12. Continuance of Probationary Term/Completion of Probation
13. Sale or Closure of Office and/or Practice
14. Notification
15. Remedial Education-Pediatric Dentistry and Oral Conscious Sedation
16. Supervised Practice
17. Clinical Training Program
Previous Names: BORRERO, MARIA CAMILA ❖ BORRERO, CAMILA
Address of Record
569 W LOWELL AVE
STE 200
TRACY CA 95376
SAN JOAQUIN 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: MARIA BORRERO DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 12042 Primary Status: Cancelled
Address :
675 CONTRA COSTA BLVD
PLEASANT HILL CA 94523
CONTRA COSTA COUNTY
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: KAUR & BORRERO DDS DENTAL CORP
License/Registration Type: Additional Office Permit
License Number: 80314 Primary Status: Expired
Address :
1801 TULLY RD SUITE A1
MODESTO CA 95350
STANISLAUS COUNTY
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: RAWLINS & LYONS DDS INC
License/Registration Type: Additional Office Permit
License Number: 79147 Primary Status: Expired
Address :
675 Contra Costa Blvd
PLEASANT HILL CA 94523-1514
LAKE COUNTY
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: BORRERO DENTAL CORP.
License/Registration Type: Additional Office Permit
License Number: 81301 Primary Status: Expired
Address :
140 E. GRANT LINE RD
TRACY CA 95376
SAN JOAQUIN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL FUN ZONE, DENTAL GROUP OF CAMILA BORRERO, DDS,
License/Registration Type: Fictitious Name Permit
License Number: 7659 Primary Status: Cancelled
Address :
569 W LOWELL BOULEVARD
TRACY CA 95376
SAN JOAQUIN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SURFSIDE KIDS DENTAL GROUP, RAWLINS & LYONS
License/Registration Type: Fictitious Name Permit
License Number: 13088 Primary Status: Expired
Address :
675 CONTRA COSTA BLVD
PLEASANT HILL CA 94523
CONTRA COSTA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SPLASH KIDS DENTAL CARE DENTAL OFFICE OF KAUR & BORRERO DDS DENTAL CORP.
License/Registration Type: Fictitious Name Permit
License Number: 15378 Primary Status: Expired
Address :
1801 TULLY RD STE A1
MODESTO CA 95350
STANISLAUS COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL FUN ZONE - BORRERO DENTAL OFFICE #2
License/Registration Type: Fictitious Name Permit
License Number: 12452 Primary Status: Cancelled
Address :
675 CONTRA COSTA BLVD
PLEASANT HILL CA 94523
CONTRA COSTA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL FUNZONE, DENTAL GROUP OF MARIA CAMILA BORRERO FONSECA, DDS
License/Registration Type: Fictitious Name Permit
License Number: 13920 Primary Status: Current - Active
Address :
569 W LOWELL BLVD STE 200
TRACY CA 95376
SAN JOAQUIN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SPARKLE KIDS DENTAL CARE, DENTAL OFFICE OF KAUR & BORRERO DDS DENTAL CORP.
License/Registration Type: Fictitious Name Permit
License Number: 16288 Primary Status: Current - Active
Address :
1801 TULLY RD., STE A.1
MODESTO CA 95350
STANISLAUS 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: CHILDREN'S DENTAL FUN ZONE, DENTAL GROUP OF CAMILA BORRERO, DDS,
License/Registration Type: Fictitious Name Permit
License Number: 7659 Primary Status: Cancelled
Address :
569 W LOWELL BOULEVARD
TRACY CA 95376
SAN JOAQUIN 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: CHILDREN'S DENTAL FUNZONE, DENTAL GROUP OF MARIA CAMILA BORRERO FONSECA, DDS
License/Registration Type: Fictitious Name Permit
License Number: 13920 Primary Status: Current - Active
Address :
569 W LOWELL BLVD STE 200
TRACY CA 95376
SAN JOAQUIN 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: SPLASH KIDS DENTAL CARE DENTAL OFFICE OF KAUR & BORRERO DDS DENTAL CORP.
License/Registration Type: Fictitious Name Permit
License Number: 15378 Primary Status: Expired
Address :
1801 TULLY RD STE A1
MODESTO CA 95350
STANISLAUS 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: KIDS HOPE DENTAL PRACTICE OF BORRERO DENTAL CORP.
License/Registration Type: Fictitious Name Permit
License Number: 17294 Primary Status: Current - Active
Address :
569 W. LOWELL AVE, STE. 200
TRACY CA 95376
SAN JOAQUIN 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: SURFSIDE KIDS DENTAL GROUP, RAWLINS & LYONS
License/Registration Type: Fictitious Name Permit
License Number: 13088 Primary Status: Expired
Address :
675 CONTRA COSTA BLVD
PLEASANT HILL CA 94523
CONTRA COSTA 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: CHILDREN'S DENTAL FUN ZONE - BORRERO DENTAL OFFICE #2
License/Registration Type: Fictitious Name Permit
License Number: 12452 Primary Status: Cancelled
Address :
675 CONTRA COSTA BLVD
PLEASANT HILL CA 94523
CONTRA COSTA 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: SPARKLE KIDS DENTAL CARE, DENTAL OFFICE OF KAUR & BORRERO DDS DENTAL CORP.
License/Registration Type: Fictitious Name Permit
License Number: 16288 Primary Status: Current - Active
Address :
1801 TULLY RD., STE A.1
MODESTO CA 95350
STANISLAUS 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: Borrero Fonseca, Maria Camila
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 947 Primary Status: Cancelled
Address :
569 W LOWELL AVE
STE 200
TRACY CA 95376
SAN JOAQUIN COUNTY
PMS 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: Pediatric Minimal Sedation Permit
Name: Borrero Fonseca, Maria Camila
License/Registration Type: Pediatric Minimal Sedation Permit
License Number: 334 Primary Status: Current - Active
Address :
569 W Lowell Ave
200
TRACY CA 95376
SAN JOAQUIN COUNTY
