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Licensing details for: 80142

Name: MOSHAR DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

6437 E. PACIFIC COAST HIGHWAY, UNIT A-6
LONG BEACH CA 90803
LOS ANGELES county
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Practice Location

6437 E. PACIFIC COAST HIGHWAY, UNIT A-6
LONG BEACH CA 90803
LOS ANGELES county
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Issuance Date

July 5, 2019

Expiration Date

January 31, 2026

Current Date / Time

June 6, 2025
11:44:4 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: JEFFERSON, WALTER

License/Registration Type: Dentist License

License Number: 53460 Primary Status: Current - Active

Address :
16475 SIERRA LAKES PKWY
STE 140
FONTANA CA 92336
SAN BERNARDINO 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: 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: MOSHAR, MEGAN ASHLEY

License/Registration Type: Dentist License

License Number: 63980 Primary Status: Current - Active

Address :
1790 W Carson St
Ste. A
TORRANCE CA 90501-7802

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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: OATES, CHRISTOPHER COLLINS

License/Registration Type: Dentist License

License Number: 58874 Primary Status: Current - Active

Address :
1559 Pacific Coast Hwy
Ste 101
HERMOSA BEACH CA 90254-3214
LOS ANGELES COUNTY

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