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Licensing details for: 79474

Name: DIMITRI DENTAL CORPORTION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

12571 LIMONITE AVE STE 230
MIRA LOMA CA 91752
RIVERSIDE county
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Practice Location

12571 LIMONITE AVE STE 230
MIRA LOMA CA 91752
RIVERSIDE county
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Issuance Date

September 25, 2017

Expiration Date

March 31, 2019

Current Date / Time

June 6, 2025
2:28:56 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: DHAMA, DEEPIKA S

License/Registration Type: Dentist License

License Number: 49044 Primary Status: Current - Active

Address :
2044 California Ave
CORONA CA 92881-3300
RIVERSIDE COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: DIMITRI, RAMI GEORGE

License/Registration Type: Dentist License

License Number: 48596 Primary Status: Current - Active

Address :
8865 E Garden View Dr
ANAHEIM CA 92808-1678
ORANGE COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: RYGG, LANCE CHRISTIAN

License/Registration Type: Dentist License

License Number: 30251 Primary Status: Cancelled

Address :
9862 E MISSION GORGE RD, STE E
SANTEE CA 92071
SAN DIEGO COUNTY

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