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Licensing details for: 18731

Name: DENTISTS OF SAN JUAN CAPISTRANO DENTAL GROUP, GHIBU DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

32391 CAMINO CAPISTRANO #B
SAN JUAN CAPISTRANO CA 92675
ORANGE county
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Practice Location

32391 CAMINO CAPISTRANO #B
SAN JUAN CAPISTRANO CA 92675
ORANGE county
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Issuance Date

July 10, 2024

Expiration Date

July 31, 2026

Current Date / Time

June 6, 2025
1:46:16 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LATSHIKYAN, ELMIRA AMY

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PANDHOH, SUMEET SWAROOP

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KANSAGRA, BINDU B

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GHIBU, ANA C

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SHETTY, SWATI

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: 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

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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: 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

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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: GHIBU, ANA C

License/Registration Type: Dentist License

License Number: 103607 Primary Status: Current - Active

Address :
32391 Camino Capistrano
B
SAN JUAN CAPISTRANO CA 92675-4519
ORANGE 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: LATSHIKYAN, ELMIRA AMY

License/Registration Type: Dentist License

License Number: 64596 Primary Status: Current - Active

Address :
130 S Main St
Suite A-D
ORANGE CA 92868-2869
ORANGE 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: PANDHOH, SUMEET SWAROOP

License/Registration Type: Dentist License

License Number: 51507 Primary Status: Expired

Address :
45 Auto Center Dr
Suite 110
FOOTHILL RANCH CA 92610-2848
ORANGE COUNTY

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