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Licensing details for: 56151

Name: KAKOLI, PAYMAN

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

18375 VENTURA BLVD #727
TARZANA CA 91356
LOS ANGELES county
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Issuance Date

August 9, 2007

Expiration Date

September 30, 2026

Current Date / Time

December 13, 2025
7:54:2 AM

License Relationships

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: A NEW SMILE DENTAL OFFICE OF KAKOLI, RAMTIN & TABIBZADEH DENTAL CORP

License/Registration Type: Fictitious Name Permit

License Number: 18436 Primary Status: Current - Active

Address :
27209 CAMP PLENTY ROAD
SANTA CLARITA CA 91351
LOS ANGELES COUNTY

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