Dental Board of California
Licensing details for: 15034
Name: DENTISTS OF IRVINE DENTAL GROUP BINDU KANSAGRA DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: REAGAN, DARIN SCOTT
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: NGUYEN, BACH XUAN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SHETTY, SWATI
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KANSAGRA, BINDU B
Address Not Disclosed
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: REAGAN, DARIN SCOTT
License/Registration Type: Dentist License
License Number: 34407 Primary Status: Current - Active
Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY
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: KANSAGRA, BINDU B
License/Registration Type: Dentist License
License Number: 57691 Primary Status: Current - Active
Address :
14415 Culver Dr
IRVINE CA 92604-0305
ORANGE COUNTY
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: NGUYEN, BACH XUAN
License/Registration Type: Dentist License
License Number: 49784 Primary Status: Current - Active
Address :
4443 Candlewood St
LAKEWOOD CA 90712-1736
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: SHETTY, SWATI
License/Registration Type: Dentist License
License Number: 50587 Primary Status: Current - Active
Address :
17160 Colima Rd Ste C
HACIENDA HEIGHTS CA 91745-6785
LOS ANGELES COUNTY
