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Licensing details for: 79591

Name: LATSHIKYAN DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

8162 E SANTA ANA CANYON RD STE 104
ANAHEIM CA 92808
ORANGE county
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Practice Location

8162 E SANTA ANA CANYON RD STE 104
ANAHEIM CA 92808
ORANGE county
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Issuance Date

February 26, 2018

Expiration Date

March 31, 2027

Current Date / Time

June 6, 2025
2:31:16 AM

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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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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: LE, VICTORIA NGUYEN

License/Registration Type: Dentist License

License Number: 59604 Primary Status: Current - Active

Address :
1905 Calle Barcelona
#206
CARLSBAD CA 92009-8450

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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: NGUYEN, BACH XUAN

License/Registration Type: Dentist License

License Number: 49784 Primary Status: Current - Active

Address :
4443 Candlewood St
LAKEWOOD CA 90712-1736

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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: LATSHIKYAN, ELMIRA AMY

License/Registration Type: Dentist License

License Number: 64596 Primary Status: Current - Active

Address :
130 S Main St
Suite A-D
ORANGE CA 92868-2869
ORANGE COUNTY

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