Dental Board of California
Licensing details for: 15643
Name: OMNI DENTAL SPECIALTY DENTAL PRACTICE OF ALIREZAEI DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KHODADADI, SOHEIL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ALIREZAEI, RAMBOD ROBBY
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KEIHANI, KOUROSH
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: 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
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: 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
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: 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
