Dental Board of California
Licensing details for: 1374
Name: PHAM, CHIEU L
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Minor
Previous Names: PHAM, CHRIS
License Relationships
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
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COASTAL KIDS FAMILY DENTISTRY DENTAL PRACTICE OF CHIEU PHAM DDS INC
License/Registration Type: Fictitious Name Permit
License Number: 17009 Primary Status: Expired
Address :
12395 EL CAMINO REAL. STE 312
SAN DIEGO CA 92130
SAN DIEGO COUNTY
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
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COASTAL KIDS DENTISTRY CARMEL VALLEY, DENTAL PRACTICE OF CHIEU PHAM DDS INC
License/Registration Type: Fictitious Name Permit
License Number: 18203 Primary Status: Current - Active
Address :
12395 El Camino Real
Ste 312
SAN DIEGO CA 92130
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
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
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
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: TORREY PINES PEDIATRIC DENTISTRY, DENTAL PRACTICE OF CHIEU PHAM
License/Registration Type: Fictitious Name Permit
License Number: 12030 Primary Status: Expired
Address :
12395 EL CAMINO REAL, #312
SAN DIEGO CA 92130
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COASTAL KIDS DENTISTRY EASTLAKE, DENTAL PRACTICE OF CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17020 Primary Status: Current - Active
Address :
2015 BIRCH RD UNIT 103
CHULA VISTA CA 91915
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COASTAL KIDS DENTISTRY SOUTH BAY, DENTAL PRACTICE OF CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17179 Primary Status: Current - Active
Address :
662 DENNERY RD STE 103
SAN DIEGO CA 92154
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COASTAL KIDS DENTISTRY SAN DIEGO, DENTAL PRACTICE OF CHIEU PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17260 Primary Status: Current - Active
Address :
2780 CARDINAL RD STE A
SAN DIEGO CA 92123
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CARMEL VALLEY PEDIATRIC DENTISTRY, DENTAL PRACTICE OF CHIEU PHAM
License/Registration Type: Fictitious Name Permit
License Number: 10797 Primary Status: Expired
Address :
12395 EL CAMINO REAL #218
SAN DIEGO CA 92130
SAN DIEGO COUNTY
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
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COASTAL KIDS DENTISTRY CARMEL VALLEY, DENTAL PRACTICE OF CHIEU PHAM D.D.S. INC.
License/Registration Type: Fictitious Name Permit
License Number: 17021 Primary Status: Expired
Address :
12395 EL CAMINO REAL STE 218
SAN DIEGO CA 92130
SAN DIEGO COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Oral Conscious Sedation Certificate
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: PHAM, CHIEU L
License/Registration Type: Dentist License
License Number: 52916 Primary Status: Current - Active
Address :
2015 Birch Rd Ste 103
CHULA VISTA CA 91915-2003
SAN DIEGO COUNTY
