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Licensing details for: 12089

Name: FARIDEH AMIN DDS, INC.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: MILLENNIUM PERIODONTICS AND IMPLANTOLOGY

Address of Record

NEWBURY RD 1000 235
NEWBURY PARK CA 91320
VENTURA county
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Practice Location

NEWBURY RD 1000 235
NEWBURY PARK CA 91320
VENTURA county
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Issuance Date

January 5, 2016

Expiration Date

October 31, 2016

Current Date / Time

June 6, 2025
2:14:22 PM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: AMIN, FARIDEH

License/Registration Type: Dentist License

License Number: 36514 Primary Status: Current - Active

Address :
1000 Newbury Rd
235
NEWBURY PARK CA 91320
VENTURA COUNTY

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