Dental Board of California
Licensing details for: 62089
Name: SHAKIL, NIDA
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
19398 Fortunello Ave
RIVERSIDE CA 92508
RIVERSIDE county
Map
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: MERCER AND SHAKIL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80992 Primary Status: Current - Active
Address :
3150 CASE RD, BLDG C
PERRIS CA 92570
RIVERSIDE 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: JUSTIN MERCER AND NIDA SHAKIL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81198 Primary Status: Current - Active
Address :
3150 CASE ROAD, BUIDLING C
PERRIS CA 92570
RIVERSIDE 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: JASON ANTONIO DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81182 Primary Status: Current - Active
Address :
28080 CLINTON KEITH ROAD, SUITE 100
MURRIETA CA 92563
RIVERSIDE 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: MERCER AND PHAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80731 Primary Status: Cancelled
Address :
3150 CASE ROAD, BUILDING C
PERRIS CA 92570
RIVERSIDE 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: MYLAD DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81681 Primary Status: Current - Active
Address :
24119 HEMLOCK AVENUE, SUITE 108
MORENO VALLEY CA 92557
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CROSSING DENTAL GROUP, MERCER AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16162 Primary Status: Cancelled
Address :
3150 CASE ROAD, BUILDING C
PERRIS CA 92570
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MORENO VALLEY MODERN DENTISTRY DENTAL GROUP, MYLAD DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18279 Primary Status: Current - Active
Address :
24119 HEMLOCK AVENUE, SUITE 108
MORENO VALLEY CA 92557
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CROSSING DENTAL GROUP, MERCER AND SHAKIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16657 Primary Status: Current - Active
Address :
3150 CASE ROAD BUILDING C
PERRIS CA 92570
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PERRIS KIDS' DENTIST DENTAL GROUP, JUSTIN MERCER AND NIDA SHAKIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17147 Primary Status: Current - Active
Address :
3150 CASE ROAD BUILDING G-2
PERRIS CA 92570
RIVERSIDE 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: CROSSING DENTAL GROUP, MERCER AND SHAKIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16657 Primary Status: Current - Active
Address :
3150 CASE ROAD BUILDING C
PERRIS CA 92570
RIVERSIDE 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: PERRIS KIDS' DENTIST DENTAL GROUP, JUSTIN MERCER AND NIDA SHAKIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17147 Primary Status: Current - Active
Address :
3150 CASE ROAD BUILDING G-2
PERRIS CA 92570
RIVERSIDE 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: MORENO VALLEY MODERN DENTISTRY DENTAL GROUP, MYLAD DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18279 Primary Status: Current - Active
Address :
24119 HEMLOCK AVENUE, SUITE 108
MORENO VALLEY CA 92557
RIVERSIDE 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: CROSSING DENTAL GROUP, MERCER AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16162 Primary Status: Cancelled
Address :
3150 CASE ROAD, BUILDING C
PERRIS CA 92570
RIVERSIDE COUNTY
