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Licensing details for: 16546

Name: CHILDREN'S DENTAL FUNZONE DENTAL OFFICE OF RODEF & KOHAN OFFICE OF VAN NUYS INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: CHILDREN'S DENTAL FUNZONE DENTAL OFFICE OF RODEF & KOHAN DENTAL OFFICE OF VAN NUYS INC. CHILDREN'S FUNZONE DENTAL OFFICE OF RODEF & KOHAN DENTAL OFFICE OF VAN NUYS INC.

Address of Record

6822 VAN NUYS BOULEVARD
VAN NUYS CA 91405
LOS ANGELES county
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Practice Location

6822 VAN NUYS BOULEVARD
VAN NUYS CA 91405
LOS ANGELES county
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Issuance Date

May 21, 2021

Expiration Date

January 31, 2027

Current Date / Time

December 13, 2025
7:53:58 AM

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: RODEF, FARIBORZ

License/Registration Type: Dentist License

License Number: 38356 Primary Status: Current - Active

Address :
2233 E GARVEY AVE N
WEST COVINA CA 91791
LOS ANGELES 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: KOHAN, FARNAZ

License/Registration Type: Dentist License

License Number: 62906 Primary Status: Current - Active

Address :
13065 Victory Blvd
13065 Victory Plaza
NORTH HOLLYWOOD CA 91606-2925
LOS ANGELES COUNTY

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