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Licensing details for: 4009

Name: GHANOUNI, SEPAND

License Type: Oral Conscious Sedation

Primary Status: Current - Active

Specialty: Adult

Address of Record

1222 COLUSA AVE. #H
YUBA CITY CA 95991
SUTTER county
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Issuance Date

May 20, 2020

Expiration Date

May 31, 2027

Current Date / Time

June 6, 2025
10:3:29 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: SACRAMENTO BRACES AND WISDOM TEETH. DENTAL GROUP OF GHANOUNI YASHARI DENTAL CORP

License/Registration Type: Fictitious Name Permit

License Number: 18902 Primary Status: Current - Active

Address :
1737 PROFESSIONAL DR
SACRAMENTO CA 95825
SACRAMENTO COUNTY

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OCS to DDS, OMS, or SP

License/Registration Role: Oral Conscious Sedation Certificate

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: GHANOUNI, SEPAND

License/Registration Type: Dentist License

License Number: 64072 Primary Status: Current - Active

Address :
1737 PROFESSIONAL DR
SACRAMENTO CA 95825
SACRAMENTO COUNTY

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