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Licensing details for: 59582

Name: SHAHROKH, ALI

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

5304 VILLAGE DR
OCEANSIDE CA 92057
SAN DIEGO county
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Practice Location

207 S El Camino Real
Ste D
ENCINITAS CA 92024-4142
SAN DIEGO county
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Issuance Date

July 27, 2010

Expiration Date

September 30, 2026

Current Date / Time

June 6, 2025
2:57:47 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: ALL SMILES DENTAL STUDIO, A DENTAL OFFICE OF SHAHROKH DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 16858 Primary Status: Current - Active

Address :
207 SOUTH EL CAMINO REAL, SUITE D
ENCINITAS CA 92024
SAN DIEGO 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: ALL SMILES DENTAL STUDIO, A DENTAL OFFICE OF SHAHROKH DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 16858 Primary Status: Current - Active

Address :
207 SOUTH EL CAMINO REAL, SUITE D
ENCINITAS CA 92024
SAN DIEGO COUNTY

Map

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