Dental Board of California
Licensing details for: 1232
Name: STAR DENTAL GROUP DR K ETEMADI
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: STAR DENTAL GROUP, DR. K. ETEMADI
Address of Record
12729 FOOTHILL BLVD SUITE A
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PAYDAR, AZADEH
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ETEMADI, KHASHAYAR
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ETEMADI, KHASHAVAR
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PAYDAR, AZADEH E
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: PAYDAR, AZADEH
License/Registration Type: Dentist License
License Number: 39695 Primary Status: Current - Active
Address :
12729 FOOTHILL BLVD
SUITE A
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY
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: ETEMADI, KHASHAYAR
License/Registration Type: Dentist License
License Number: 40432 Primary Status: Current - Active
Address :
12729 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY
