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Licensing details for: 80707

Name: JABAITI DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1708 S. VICTORIA AVE. STE B
VENTURA CA 93003
VENTURA county
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Practice Location

1708 S. VICTORIA AVE. STE B
VENTURA CA 93003
VENTURA county
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Issuance Date

November 5, 2020

Expiration Date

September 30, 2025

Current Date / Time

June 6, 2025
3:33:42 PM

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: KEIHANI, KOUROSH

License/Registration Type: Dentist License

License Number: 63776 Primary Status: Current - Active

Address :
1730 E Gonzales Rd
OXNARD CA 93036-3701
VENTURA 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: KHODADADI, SOHEIL

License/Registration Type: Dentist License

License Number: 39024 Primary Status: Current - Active

Address :
8500 Wilshire Blvd
SUITE 527
BEVERLY HILLS CA 90211-3121
LOS ANGELES 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: JABAITI, TARIQ

License/Registration Type: Dentist License

License Number: 102526 Primary Status: Current - Active

Address :
16740 Otsego St
ENCINO CA 91436-1030
LOS ANGELES 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: ALIREZAEI, RAMBOD ROBBY

License/Registration Type: Dentist License

License Number: 48872 Primary Status: Current - Active

Address :
11633 San Vicente Blvd Ste 210
LOS ANGELES CA 90049-6513
LOS ANGELES COUNTY

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