Dental Board of California
Licensing details for: 64535
Name: NASIRI, AVISHAN KOLAHDOUZ
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
3500 Barranca Pkwy
Suite 270
IRVINE CA 92606
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BOUTIQUE FAMILY DENTISTRY DENTAL OFFICE OF DR. AVISHAN K. NASIRI
License/Registration Type: Fictitious Name Permit
License Number: 13558 Primary Status: Cancelled
Address :
801 N Tustin Ave Ste 504
SANTA ANA CA 92705-3609
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BOUTIQUE FAMILY DENTISTRY DENTAL OFFICE OF DR. AVISHAN K. NASIRI
License/Registration Type: Fictitious Name Permit
License Number: 18872 Primary Status: Current - Active
Address :
3500 BARRANCA PKWY STE 270
IRVINE CA 92606
ORANGE 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: BOUTIQUE FAMILY DENTISTRY DENTAL OFFICE OF DR. AVISHAN K. NASIRI
License/Registration Type: Fictitious Name Permit
License Number: 13558 Primary Status: Cancelled
Address :
801 N Tustin Ave Ste 504
SANTA ANA CA 92705-3609
ORANGE 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: BOUTIQUE FAMILY DENTISTRY DENTAL OFFICE OF DR. AVISHAN K. NASIRI
License/Registration Type: Fictitious Name Permit
License Number: 18872 Primary Status: Current - Active
Address :
3500 BARRANCA PKWY STE 270
IRVINE CA 92606
ORANGE COUNTY
