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Licensing details for: 10668

Name: HERMOSA SMILES DENTISTRY DENTAL GROUP, OATES AND JEFFERSON DENTAL

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: HERMOSA SMILES DENTISTRY DENTAL GROUP OATS AND JEFFERSON DENTAL CORPORATION

Address of Record

1559 Pacific Coast Hwy Ste 101
HERMOSA BEACH CA 90254-3214
LOS ANGELES county
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Practice Location

1559 PACIFIC COAST HWY SUITE 101
HERMOSA BEACH CA 90254
LOS ANGELES county
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Issuance Date

August 28, 2013

Expiration Date

November 30, 2026

Current Date / Time

June 6, 2025
2:6:9 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: JEFFERSON, WALTER

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REAGAN, DARIN SCOTT

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: OATES, CHRISTOPHER COLLINS

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SHARIFIAN, ALEX R.

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: 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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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: 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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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: 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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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: SHARIFIAN, ALEX R.

License/Registration Type: Dentist License

License Number: 44540 Primary Status: Current - Active

Address :
13721 Newport Ave
Suite 1
TUSTIN CA 92780-4690
ORANGE COUNTY

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