Dental Board of California
Licensing details for: 62763
Name: EBRAHIMI, HOUMAN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CANYON SMILES & ORTHODONTICS DENTAL OFFICE OF DRS EBRAHIMI AND BALAZADEH
License/Registration Type: Fictitious Name Permit
License Number: 17550 Primary Status: Current - Active
Address :
18279 SOLEDAD CANYON RD
CANYON COUNTRY CA 91387
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: CANYON SMILES & ORTHODONTICS DENTAL OFFICE OF DRS EBRAHIMI AND BALAZADEH
License/Registration Type: Fictitious Name Permit
License Number: 17550 Primary Status: Current - Active
Address :
18279 SOLEDAD CANYON RD
CANYON COUNTRY CA 91387
LOS ANGELES COUNTY
Registered Dental Hygienist Alternative Practice to Dentist
License/Registration Role: Dentist
Related Party Role: Registered Dental Hygienist Alternative Practice
Name: FLETCHER, ADRIANNE MARLENE
License/Registration Type: Registered Dental Hygienist Alternative Practice
License Number: 744 Primary Status: Current - Active
Address Not Disclosed
