Dental Board of California
Licensing details for: 12620
Name: ELITE DENTAL SPECIALISTS, DENTAL OFFICE OF FARIDEH AMIN
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: MILLENNIUM PERIODONTICS AND IMPLANTOLOGY GROUP
Address of Record
10244-1 CANOGA AVENUE
CHATSWORTH CA 91311
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: AMIN, FARIDEH
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: AMIN, FARIDEH
License/Registration Type: Dentist License
License Number: 36514 Primary Status: Current - Active
Address :
1000 Newbury Rd
235
NEWBURY PARK CA 91320
VENTURA COUNTY
