
Dental Board of California
Licensing details for: 17198
Name: DENTAL GROUP OF BEVERLY HILLS PRACTICE OF KEIHANI 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: KEIHANI, KOUROSH
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: JABAITI, TARIQ
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: 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
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: 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