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Licensing details for: 61986

Name: MAUSETH, SPENCER EUGENE

License Type: Dentist

Primary Status: Current - Active

Address of Record

16918 Dove Canyon Rd
#203
SAN DIEGO CA 92127-3445
SAN DIEGO county
Map

Issuance Date

October 15, 2012

Expiration Date

October 31, 2025

Current Date / Time

June 6, 2025
3:7:2 PM

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: 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

Map

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: 79675 Primary Status: Cancelled

Address :
110 Town Center Pkwy
Suite A
SANTEE CA 92071-5801
SAN DIEGO COUNTY

Map

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: 79650 Primary Status: Current - Active

Address :
135 SAXONY RD STE 200
ENCINITAS CA 92024-3791
SAN DIEGO COUNTY

Map

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

Map

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

Map

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

Map

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 AND MAUSETH DDS INC

License/Registration Type: Additional Office Permit

License Number: 79719 Primary Status: Current - Active

Address :
16918 DOVE CANYON RD STE 209
SAN DIEGO CA 92127
SAN DIEGO COUNTY

Map

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

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: 4S PEDIATRIC DENTISTRY, DENTAL PRACTICE OF PHAM AND MAUSETH DDS I

License/Registration Type: Fictitious Name Permit

License Number: 12029 Primary Status: Current - Active

Address :
16918 DOVE CANYON ROAD #203
SAN DIEGO CA 92127
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: ENCINITAS PEDIATRIC DENTISTRY DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC

License/Registration Type: Fictitious Name Permit

License Number: 13289 Primary Status: Current - Active

Address :
135 SAXONY ROAD, #200
ENCINITAS CA 92024
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CONVOY DENTAL, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 14312 Primary Status: Expired

Address :
3820 CONVOY ST.
SAN DIEGO CA 92111
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: STEEL CANYON SMILES DENTAL, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 14311 Primary Status: Expired

Address :
2990 JAMACHA RD. STE 132
EL CAJON CA 92019
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

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

Map

FNP Owners

License/Registration Role: Owners

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

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: SAN ELIJO PEDIATRIC DENTAL PRACTICE & ORTHODONTICS DR. MAUSETH

License/Registration Type: Fictitious Name Permit

License Number: 17290 Primary Status: Current - Active

Address :
1640 SAN ELIJO ROAD #101
SAN MARCOS CA 92078
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

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

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: SONRISA DENTAL, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 14310 Primary Status: Expired

Address :
510 BROADWAY UNIT 4
CHULA VISTA CA 91910
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: RADIANT SMILES DENTAL OFFICE OF PHAM AND MAUSETH DDS INC

License/Registration Type: Fictitious Name Permit

License Number: 14206 Primary Status: Current - Active

Address :
16918 DOVE CANYON RD STE 209
SAN DIEGO CA 92127
SAN DIEGO COUNTY

Map

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: STEEL CANYON SMILES DENTAL, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 14311 Primary Status: Expired

Address :
2990 JAMACHA RD. STE 132
EL CAJON CA 92019
SAN DIEGO COUNTY

Map

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

Map

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

Map

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: RADIANT SMILES DENTAL OFFICE OF PHAM AND MAUSETH DDS INC

License/Registration Type: Fictitious Name Permit

License Number: 14206 Primary Status: Current - Active

Address :
16918 DOVE CANYON RD STE 209
SAN DIEGO CA 92127
SAN DIEGO COUNTY

Map

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: 4S PEDIATRIC DENTISTRY, DENTAL PRACTICE OF PHAM AND MAUSETH DDS I

License/Registration Type: Fictitious Name Permit

License Number: 12029 Primary Status: Current - Active

Address :
16918 DOVE CANYON ROAD #203
SAN DIEGO CA 92127
SAN DIEGO COUNTY

Map

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: SAN ELIJO PEDIATRIC DENTAL PRACTICE & ORTHODONTICS DR. MAUSETH

License/Registration Type: Fictitious Name Permit

License Number: 17290 Primary Status: Current - Active

Address :
1640 SAN ELIJO ROAD #101
SAN MARCOS CA 92078
SAN DIEGO COUNTY

Map

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

Map

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: SONRISA DENTAL, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 14310 Primary Status: Expired

Address :
510 BROADWAY UNIT 4
CHULA VISTA CA 91910
SAN DIEGO COUNTY

Map

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: ENCINITAS PEDIATRIC DENTISTRY DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC

License/Registration Type: Fictitious Name Permit

License Number: 13289 Primary Status: Current - Active

Address :
135 SAXONY ROAD, #200
ENCINITAS CA 92024
SAN DIEGO COUNTY

Map

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: CONVOY DENTAL, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.

License/Registration Type: Fictitious Name Permit

License Number: 14312 Primary Status: Expired

Address :
3820 CONVOY ST.
SAN DIEGO CA 92111
SAN DIEGO COUNTY

Map

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: MAUSETH, SPENCER EUGENE

License/Registration Type: Oral Conscious Sedation Certificate

License Number: 2853 Primary Status: Cancelled

Address :
16918 Dove Canyon Rd Ste 203
SAN DIEGO CA 92127-3457
SAN DIEGO COUNTY

Map

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