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Licensing details for: 81455

Name: SOOD AND FAREID DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1193 E. CHAMPLAIN DRIVE
FRESNO CA 93720
FRESNO county
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Practice Location

1193 E. CHAMPLAIN DRIVE
FRESNO CA 93720
FRESNO county
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Issuance Date

March 2, 2023

Expiration Date

July 31, 2027

Current Date / Time

November 4, 2025
1:53:12 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: VICUNA, SERGIO

License/Registration Type: Dentist License

License Number: 53129 Primary Status: Current - Active

Address :
5004 S Land Park Dr
SACRAMENTO CA 95822-2504
SACRAMENTO 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: FAREID, BEVAN SHOGHI

License/Registration Type: Dentist License

License Number: 64702 Primary Status: Current - Active

Address :
4129 S Mooney Blvd #B
VISALIA CA 93277
TULARE 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: LOPEZ, MICHAEL JAMES

License/Registration Type: Dentist License

License Number: 57591 Primary Status: Expired

Address :
1556 Aria Ct
LIVERMORE CA 94550-6077
ALAMEDA 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: SOOD, KUNAL

License/Registration Type: Dentist License

License Number: 104953 Primary Status: Current - Active

Address :
1095 Herndon Ave
Ste102
CLOVIS CA 93612-0504
FRESNO 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: GILL, AMARDEEP KAUR

License/Registration Type: Dentist License

License Number: 50464 Primary Status: Current - Active

Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO COUNTY

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