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Licensing details for: 430

Name: PEDDIREDDY, DIVYA REDDY

License Type: Moderate Sedation Permit

Primary Status: Current - Active

Practice Location

3070 BRISTOL STREE, SUITE 180
COSTA MESA CA 92626
ORANGE county
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Issuance Date

May 3, 2024

Expiration Date

February 28, 2026

Current Date / Time

June 6, 2025
1:18:56 PM

License Relationships

MS to DDS or OMS or SP

License/Registration Role: Moderate Sedation Permit

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

Name: PEDDIREDDY, DIVYA REDDY

License/Registration Type: Dentist License

License Number: 62530 Primary Status: Current - Active

Address :
184 STONECLIFFE AISLE
IRVINE CA 92603
ORANGE COUNTY

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