Dental Board of California
Licensing details for: 64496
Name: REIZIAN, ALEXANDROS MIHALIS
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
4711 MONROE AVE
SAN DIEGO CA 92115-3202
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: TALMADGE FAMILY DENTAL DENTAL PRACTICE OF ALEXANDROS REIZIAN
License/Registration Type: Fictitious Name Permit
License Number: 17467 Primary Status: Current - Active
Address :
4711 MONROE AVE
SAN DIEGO CA 92115
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: TALMADGE FAMILY DENTAL DENTAL PRACTICE OF ALEXANDROS REIZIAN
License/Registration Type: Fictitious Name Permit
License Number: 17467 Primary Status: Current - Active
Address :
4711 MONROE AVE
SAN DIEGO CA 92115
SAN DIEGO 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: REIZIAN, ALEXANDROS MIHALIS
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 3490 Primary Status: Current - Active
Address :
4711 Monroe Ave
SAN DIEGO CA 92115-3202
SAN DIEGO COUNTY
