Dental Board of California
Licensing details for: 10026
Name: LAX DENTAL GROUP, VAHEDI AND KHAKSHOOY DENTAL INCORPORATION
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: LAX DENTAL GROUP
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KHAKSHOOY, SIAMAK
Address Not Disclosed
FNP to DDS or OMS
License/Registration Role: Fictitious Name 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
