Dental Board of California
Licensing details for: 12350
Name: MODESTO KIDZ DENTAL, DENTAL PRACTICE OF SHEIKH AND SHELAT DDS INC
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: MODESTO KIDZ DENTAL
Address of Record
2801 COFFEE ROAD, BUILDING B
MODESTO CA 95355
STANISLAUS county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SHELAT, BHAVINI HARISH
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SHEIKH, HASEEB NISAR
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: SHELAT, BHAVINI HARISH
License/Registration Type: Dentist License
License Number: 56738 Primary Status: Current - Active
Address :
4232 ACCLAIM WAY
MODESTO CA 95356
STANISLAUS 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: SHEIKH, HASEEB NISAR
License/Registration Type: Dentist License
License Number: 56248 Primary Status: Current - Active
Address :
2801 COFFEE RD BLDG- B
MODESTO CA 95355
STANISLAUS COUNTY
