Dental Board of California
Licensing details for: 62682
Name: GENISH, ADI AVITAL
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
350 S Beverly Dr
Suite 350
BEVERLY HILLS CA 90212-4811
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: KUSP BEVERLY HILLS PEDIATRIC DENTAL PRACTICE OF DR. ADI GENISH
License/Registration Type: Fictitious Name Permit
License Number: 18031 Primary Status: Current - Active
Address :
350 S. BEVERLY DR. SUITE 350
BEVERLY HILLS CA 90212
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: KUSP BEVERLY HILLS PEDIATRIC DENTAL GROUP OF DRS GENISH AND WEINGARTEN
License/Registration Type: Fictitious Name Permit
License Number: 17785 Primary Status: Cancelled
Address :
350 S BEVERLY DR STE 350
BEVERLY HILLS CA 90212
LOS ANGELES 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: KUSP BEVERLY HILLS PEDIATRIC DENTAL PRACTICE OF DR. ADI GENISH
License/Registration Type: Fictitious Name Permit
License Number: 18031 Primary Status: Current - Active
Address :
350 S. BEVERLY DR. SUITE 350
BEVERLY HILLS CA 90212
LOS ANGELES 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: KUSP BEVERLY HILLS PEDIATRIC DENTAL GROUP OF DRS GENISH AND WEINGARTEN
License/Registration Type: Fictitious Name Permit
License Number: 17785 Primary Status: Cancelled
Address :
350 S BEVERLY DR STE 350
BEVERLY HILLS CA 90212
LOS ANGELES 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: GENISH, ADI AVITAL
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 3382 Primary Status: Cancelled
Address :
7811 COWPER AVENUE
WEST HILLS CA 91304
LOS ANGELES 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: GENISH, ADI AVITAL
License/Registration Type: Pediatric Minimal Sedation Permit
License Number: 103 Primary Status: Current - Active
Address :
350 S BEVERLY DR. SUITE 350
BEVERLY HILLS CA 90212
LOS ANGELES COUNTY
