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Licensing details for: 13264

Name: GRANITE BAY SMILES DENTISTRY DENTAL GROUP KAHBODY DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

8630 SIERRA COLLEGE BOULEVARD, SUITE 110
ROSEVILLE CA 95661
PLACER county
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Practice Location

8630 SIERRA COLLEGE BOULEVARD, STE 110
ROSEVILLE CA 95661
PLACER county
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Issuance Date

January 6, 2017

Expiration Date

December 31, 2024

Current Date / Time

November 2, 2025
3:28:4 PM

License Relationships

FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

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

Name: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

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

Name: KAHBODY, TARANEH

License/Registration Type: Dentist License

License Number: 42058 Primary Status: Current - Active

Address :
4690 Natomas Blvd
Ste 100
SACRAMENTO CA 95835-2230
SACRAMENTO COUNTY

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FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

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

Name: LAMBRIDIS, DEAN

License/Registration Type: Dentist License

License Number: 51199 Primary Status: Current - Active

Address :
30831 MARSEILLE WAY
WESTLAKE VILLAGE CA 91362
VENTURA COUNTY

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FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

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

Name: GILL, AMARDEEP KAUR

License/Registration Type: Dentist License

License Number: 50464 Primary Status: Current - Active

Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO COUNTY

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