Dental Board of California
Licensing details for: 58240
Name: SHAH, AMIT ASHOK
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BEACH HOUSE PEDIATRIC DENTISTRY DENTAL PRACTICE OF AMIT A. SHAH D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 14778 Primary Status: Current - Active
Address :
18377 BEACH BLVD STE 216
HUNTINGTON BEACH CA 92648
ORANGE 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: BEACH HOUSE PEDIATRIC DENTISTRY DENTAL PRACTICE OF AMIT A. SHAH D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 14778 Primary Status: Current - Active
Address :
18377 BEACH BLVD STE 216
HUNTINGTON BEACH CA 92648
ORANGE 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: SHAH, AMIT ASHOK
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 2028 Primary Status: Cancelled
Address :
18377 Beach Blvd Ste 216
HUNTINGTON BEACH CA 92648-1349
ORANGE COUNTY
