Dental Board of California
Licensing details for: 56393
Name: TANG, SOPHEAP
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
18876 Van Buren Blvd.
STE 107
RIVERSIDE CA 92508
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: SOPHEAP TANG, DMD, DENTAL CORP.
License/Registration Type: Additional Office Permit
License Number: 10821 Primary Status: Current - Active
Address :
31577 CANYON ESTATES DR.
STE. 200
LAKE ELSINORE CA 92532
RIVERSIDE COUNTY
CS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Conscious Sedation Permit
Name: TANG, SOPHEAP
License/Registration Type: Conscious Sedation Permit
License Number: 639 Primary Status: Cancelled
Address :
18876 Van Buren Blvd.
STE 107
RIVERSIDE CA 92508
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: A TOOTH FAIRY DENTAL OFFICE, SOPHEAP TANG, DMD, DENTAL CORPORATIO
License/Registration Type: Fictitious Name Permit
License Number: 9597 Primary Status: Cancelled
Address :
19040 VAN BUREN BOULEVARD, STE. 111
RIVERSIDE CA 92508
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: A TOOTH FAIRY DENTAL OFFICE OF SOPHEAP TANG, DMD
License/Registration Type: Fictitious Name Permit
License Number: 7613 Primary Status: Cancelled
Address :
19040 VAN BUREN BLVD.
STE. 111
RIVERSIDE CA 92508
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: A TOOTH FAIRY DENTAL OFFICE, SOPHEAP TANG, DMD, DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15655 Primary Status: Current - Active
Address :
18876 VAN BUREN BLVD ., STE 107
RIVERSIDE CA 92508
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: A TOOTH FAIRY DENTAL OFFICE OF SOPHEAP TANG, DMD
License/Registration Type: Fictitious Name Permit
License Number: 7613 Primary Status: Cancelled
Address :
19040 VAN BUREN BLVD.
STE. 111
RIVERSIDE CA 92508
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: A TOOTH FAIRY DENTAL OFFICE, SOPHEAP TANG, DMD, DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15655 Primary Status: Current - Active
Address :
18876 VAN BUREN BLVD ., STE 107
RIVERSIDE CA 92508
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: A TOOTH FAIRY DENTAL OFFICE, SOPHEAP TANG, DMD, DENTAL CORPORATIO
License/Registration Type: Fictitious Name Permit
License Number: 9597 Primary Status: Cancelled
Address :
19040 VAN BUREN BOULEVARD, STE. 111
RIVERSIDE CA 92508
RIVERSIDE COUNTY
