Dental Board of California
Licensing details for: 19111
Name: ORANGE MODERN DENTISTRY DENTAL GROUP, ELMIRA LATSHIKYAN 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: SHETTY, SWATI
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: 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 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
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
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
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
