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Licensing details for: 104197

Name: TAHA, SAHAR

License Type: Dentist

Primary Status: Current - Active

Secondary Status: Completed LBC Clinical Contract

Address of Record

6660 Lone Tree Way
BRENTWOOD CA 94513-5370
CONTRA COSTA county
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Contract Location

1200 WEST MAIN STREET
TURLOCK CA 95380
STANISLAUS county
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Issuance Date

July 31, 2019

Expiration Date

December 31, 2025

Current Date / Time

June 7, 2025
5:23:15 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: BRENTWOOD SMILES DENTISTRY DENTAL GROUP, MOKBIL AND TAHA DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 19175 Primary Status: Current - Active

Address :
6660 LONE TREE WAY, SUITE 7
BRENTWOOD CA 94513
CONTRA COSTA COUNTY

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FNP to DDS or OMS

License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Related Party Role: Fictitious Name Permit

Name: BRENTWOOD SMILES DENTISTRY DENTAL GROUP, MOKBIL AND TAHA DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 19175 Primary Status: Current - Active

Address :
6660 LONE TREE WAY, SUITE 7
BRENTWOOD CA 94513
CONTRA COSTA COUNTY

Map

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