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Licensing details for: 19057

Name: LAWNDALE DENTAL GROUP, DENTAL OFFICE OF BANDARY & BAROOTY, DDS, A PROFESSIONAL DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

15228 HAWTHORNE BLVD. SUITE A
LAWNDALE CA 90260
LOS ANGELES county
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Practice Location

15228 HAWTHORNE BLVD. SUITE A
LAWNDALE CA 90260
LOS ANGELES county
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Issuance Date

November 12, 2024

Expiration Date

October 31, 2026

Current Date / Time

June 6, 2025
10:6:10 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BAROOTY, ARIAN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BANDARY, DANIEL

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: BANDARY, DANIEL

License/Registration Type: Dentist License

License Number: 107388 Primary Status: Current - Active

Address :
18235 ROSITA ST
TARZANA CA 91356
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: BAROOTY, ARIAN

License/Registration Type: Dentist License

License Number: 105146 Primary Status: Current - Active

Address :
1295 S La Brea Ave
ste 101
INGLEWOOD CA 90301-1066
LOS ANGELES COUNTY

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