Dental Board of California
Licensing details for: 59609
Name: ARIANNEJAD, SHAHAB
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
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: SHAHAB ARIANNEJAD DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81392 Primary Status: Current - Active
Address :
8400 CENTER DRIVE
LA MESA CA 91942
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: ARIANNEJAD AND PHAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80166 Primary Status: Current - Active
Address :
5620 LAKE MURRAY BLVD.
LA MESA CA 91942
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: ARIANNEJAD AND PHAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81653 Primary Status: Expired
Address :
5620 LAKE MURRAY BLVD
LA MESA CA 91942
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: ARIANNEJAD AND PHAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79181 Primary Status: Cancelled
Address :
5620 Lake Murray Blvd
LA MESA CA 91942-1981
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: LA MESA MODERN DENTAL GROUP ARIANNEJAD AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13249 Primary Status: Cancelled
Address :
5620 LAKE MURRAY BLVD.
LA MESA CA 91942
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: DENTISTS OF GROSSMONT DENTAL GROUP, SHAHAB ARIANNEJAD DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16921 Primary Status: Current - Active
Address :
8400 Center Drive
LA MESA CA 91942
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: LA MESA MODERN DENTAL GROUP ARIANNEJAD AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15132 Primary Status: Cancelled
Address :
5620 LAKE MURRAY BLVD
LA MESA CA 91942
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: LA MESA MODERN DENTAL GROUP,, ARIANNEJAB AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17946 Primary Status: Current - Active
Address :
5620 LAKE MURRAY BLVD
LA MESA CA 91942
SAN DIEGO COUNTY
