Dental Board of California
Licensing details for: 51062
Name: EL FARRA, MOHAMMAD YAZEED
License Type: Dentist
Primary Status: Current - Active
Previous Names: EL FARRA, MOHAMMAD
Address of Record
1507 W YOSEMITE AVE
MANTECA CA 95337
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: R. CICCARELLI, DDS., R. JOSEPH, DDS., M. EI FARRA, DDS., D. SAINI, DDS., INC.
License/Registration Type: Additional Office Permit
License Number: 79075 Primary Status: Expired
Address :
1511 W Yosemite Ave
MANTECA CA 95337-5159
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: VALLEY OAK DENTAL GROUP, R. CICCARELLI, DDS., R. JOSEPH, DDS., M.
License/Registration Type: Fictitious Name Permit
License Number: 9158 Primary Status: Current - Active
Address :
1507 W YOSEMITE AVENUE
MANTECA CA 95337
SAN JOAQUIN 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: EL FARRA, MOHAMMAD YAZEED
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 739 Primary Status: Cancelled
Address :
1507 W YOSEMITE AVE
MANTECA CA 95337
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: EL FARRA, MOHAMMAD YAZEED
License/Registration Type: Pediatric Minimal Sedation Permit
License Number: 135 Primary Status: Current - Active
Address :
1507 W. YOSEMITE AVE.
MANTECA CA 95337
SAN JOAQUIN COUNTY
Registered Dental Hygienist Alternative Practice to Dentist
License/Registration Role: Dentist
Related Party Role: Registered Dental Hygienist Alternative Practice
Name: TERRY, LORETTA MARISA
License/Registration Type: Registered Dental Hygienist Alternative Practice
License Number: 203 Primary Status: Current - Active
Address Not Disclosed
