Dental Board of California

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: SMILE DENTAL DENTAL OFFICE OF EUGENIE KIM

License/Registration Type: Fictitious Name Permit

License Number: 14562 Primary Status: Current - Active

Address :
12190 PERRIS BLVD, STE D
MORENO VALLEY CA 92557
RIVERSIDE COUNTY

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License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: LUMINOUS DENTAL SPA, DENTAL GROUP OF E KIM DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 18332 Primary Status: Expired

Address :
1400 REYNOLDS AVE., STE 150
IRVINE CA 92614
ORANGE COUNTY

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License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: VALLEY DESERT DENTIST

License/Registration Type: Fictitious Name Permit

License Number: 13326 Primary Status: Current - Active

Address :
21580 BEAR VALLEY RD #B2-2
APPLE VALLEY CA 92308
SAN BERNARDINO COUNTY

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License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: VIVE DENTAL OFFICE OF EUGENIE KIM

License/Registration Type: Fictitious Name Permit

License Number: 14896 Primary Status: Expired

Address :
11201 CALIFORNIA ST., STE D
REDLANDS CA 92373
SAN BERNARDINO COUNTY

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License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: DESERT DENTIST DENTAL OFFICE OF EUGENIE KIM

License/Registration Type: Fictitious Name Permit

License Number: 14563 Primary Status: Current - Active

Address :
14661 MAIN ST
HESPERIA CA 92345
SAN BERNARDINO COUNTY

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License/Registration Role: Moderate Sedation Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: KIM, EUGENIE HEO

License/Registration Type: Dentist License

License Number: 62603 Primary Status: Current - Active

Address :
62 SWIFT
IRVINE CA 92618-1705
ORANGE COUNTY

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