Dental Board of California
Licensing details for: 52916
Name: PHAM, CHIEU L
License Type: Dentist
Primary Status: Current - Active
Previous Names: PHAM, CHRIS
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: BPM DENTAL PARTNERSHIP
License/Registration Type: Additional Office Permit
License Number: 81131 Primary Status: Expired
Address :
110 TOWN CENTER PKWY
SANTEE CA 92071
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81269 Primary Status: Expired
Address :
2780 CARDINAL RD STE A
SAN DIEGO CA 92123
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHAM & MAUSETH, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 79889 Primary Status: Cancelled
Address :
2900 JAMACHA RD. STE 132
EL CAJON CA 92019
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: SAN ELIJO DENTISTRY, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.
License/Registration Type: Additional Office Permit
License Number: 79891 Primary Status: Cancelled
Address :
510 BROADWAY STE 4
CHULA VISTA CA 91910
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHAM & MAUSETH, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 79890 Primary Status: Cancelled
Address :
3820 CONVOY STREET
SAN DIEGO CA 92111
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHAM & MAUSETH, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 79651 Primary Status: Cancelled
Address :
1761 PALM AVE
SAN DIEGO CA 92154-1150
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: CHIEU PHAM DDS INC
License/Registration Type: Additional Office Permit
License Number: 81132 Primary Status: Expired
Address :
12395 EL CAMINO REAL. STE 312
SAN DIEGO CA 92130
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: CHIEU PHAM DDS
License/Registration Type: Additional Office Permit
License Number: 10887 Primary Status: Expired
Address :
16918 DOVE CANYON RD #203
SAN DIEGO CA 92127
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81285 Primary Status: Expired
Address :
662 DENNERY RD STE 103
SAN DIEGO CA 92154
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81133 Primary Status: Expired
Address :
2015 BIRCH RD UNIT 103
CHULA VISTA CA 91915
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHAM & MAUSETH, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 79649 Primary Status: Cancelled
Address :
2015 BIRCH RD STE 103
CHULA VISTA CA 91915-2003
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: CHIEU PHAM DDS INC
License/Registration Type: Additional Office Permit
License Number: 11806 Primary Status: Cancelled
Address :
12395 EL CAMINO ROAD
#312
SAN DIEGO CA 92130
SAN DIEGO COUNTY
CS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Conscious Sedation Permit
Name: PHAM, CHIEU L
License/Registration Type: Conscious Sedation Permit
License Number: 547 Primary Status: Cancelled
Address :
12395 EL CAMINO REAL SUITE 218
SAN DIEGO CA 92130
SAN DIEGO COUNTY
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: EASTLAKE PEDIATRIC DENTISTRY, DENTAL OFFICE OF PHAM AND MAUSETH DDS INC.
License/Registration Type: Fictitious Name Permit
License Number: 14748 Primary Status: Expired
Address :
2015 BIRCH RD STE 103
CHULA VISTA CA 91915
SAN DIEGO COUNTY
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: CARMEL VALLEY PEDIATRIC DENTISTRY, DENTAL PRACTICE OF CHIEU PHAM
License/Registration Type: Fictitious Name Permit
License Number: 10797 Primary Status: Expired
Address :
12395 EL CAMINO REAL #218
SAN DIEGO CA 92130
SAN DIEGO COUNTY
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: TORREY PINES PEDIATRIC DENTISTRY, DENTAL PRACTICE OF CHIEU PHAM
License/Registration Type: Fictitious Name Permit
License Number: 12030 Primary Status: Expired
Address :
12395 EL CAMINO REAL, #312
SAN DIEGO CA 92130
SAN DIEGO COUNTY
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: COASTAL KIDS DENTISTRY EASTLAKE, DENTAL PRACTICE OF CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17020 Primary Status: Expired
Address :
2015 BIRCH RD UNIT 103
CHULA VISTA CA 91915
SAN DIEGO COUNTY
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: COASTAL KIDS DENTISTRY SOUTH BAY, DENTAL PRACTICE OF CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17179 Primary Status: Expired
Address :
662 DENNERY RD STE 103
SAN DIEGO CA 92154
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: PALM AVENUE DENTAL OFFICE OF PHAM AND MAUSETH DDS INC.
License/Registration Type: Fictitious Name Permit
License Number: 14690 Primary Status: Cancelled
Address :
1761 PALM AVE
SAN DIEGO CA 92154-1150
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: COASTAL KIDS DENTISTRY CARMEL VALLEY, DENTAL PRACTICE OF CHIEU PHAM DDS INC
License/Registration Type: Fictitious Name Permit
License Number: 18203 Primary Status: Expired
Address :
12395 El Camino Real
Ste 312
SAN DIEGO CA 92130
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: COASTAL KIDS DENTISTRY SAN DIEGO, DENTAL PRACTICE OF CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17260 Primary Status: Expired
Address :
2780 CARDINAL RD STE A
SAN DIEGO CA 92123
SAN DIEGO COUNTY
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: COASTAL KIDS FAMILY DENTISTRY DENTAL PRACTICE OF CHIEU PHAM DDS INC
License/Registration Type: Fictitious Name Permit
License Number: 17009 Primary Status: Expired
Address :
12395 EL CAMINO REAL. STE 312
SAN DIEGO CA 92130
SAN DIEGO COUNTY
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: SANTEE PEDIATRIC DENTISTRY, DENTAL PRACTICE OF BPM DENTAL PARTNERSHIP
License/Registration Type: Fictitious Name Permit
License Number: 13896 Primary Status: Cancelled
Address :
110 TOWN CENTER PKWY STE A
SANTEE CA 92071
SAN DIEGO COUNTY
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: COASTAL KIDS DENTISTRY CARMEL VALLEY, DENTAL PRACTICE OF CHIEU PHAM D.D.S. INC.
License/Registration Type: Fictitious Name Permit
License Number: 17021 Primary Status: Expired
Address :
12395 EL CAMINO REAL STE 218
SAN DIEGO CA 92130
SAN DIEGO COUNTY
MS to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Moderate Sedation Permit
Name: PHAM, CHIEU L
License/Registration Type: Moderate Sedation Permit
License Number: 713 Primary Status: Current - Active
Address :
678 3rd Ave
CHULA VISTA CA 91910-5736
SAN DIEGO COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: PHAM, CHIEU L
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 1374 Primary Status: Cancelled
Address :
12395 El Camino Real Ste 218
SAN DIEGO CA 92130-3084
SAN DIEGO COUNTY
PMS to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Pediatric Minimal Sedation Permit
Name: PHAM, CHIEU L
License/Registration Type: Pediatric Minimal Sedation Permit
License Number: 434 Primary Status: Current - Active
Address :
110 Town Center Pkwy
#A
SANTEE CA 92071
SAN DIEGO COUNTY
