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Licensing details for: 81086

Name: DRS. SIAMAK KHAKSHOOY & SOHEIL VAHEDI DDS, INC.

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Practice Location

3451 W. CENTURY BLVD., STE B-1
INGLEWOOD CA 90303
LOS ANGELES county
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Issuance Date

November 19, 2021

Expiration Date

November 30, 2022

Current Date / Time

June 6, 2025
10:30:24 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: KHAKSHOOY, SIAMAK

License/Registration Type: Dentist License

License Number: 54539 Primary Status: Current - Active

Address :
3451 W CENTURY BLVD STE# B-1
INGLEWOOD CA 90304
LOS ANGELES 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: VAHEDI, SOHEIL

License/Registration Type: Dentist License

License Number: 54735 Primary Status: Current - Active

Address :
2621 E 1st St
2621 E. 1st Street
LOS ANGELES CA 90033-3505

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