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Licensing details for: 13142

Name: DENTISTS OF SOUTH PASADENA DENTAL GROUP MARTIN GALSTYAN DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

813 FAIR OAKS AVENUE
SOUTH PASADENA CA 91030
LOS ANGELES county
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Practice Location

813 FAIR OAKS AVENUE
SOUTH PASADENA CA 91030
LOS ANGELES county
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Issuance Date

November 9, 2016

Expiration Date

July 31, 2022

Current Date / Time

June 6, 2025
2:11:21 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GALSTYAN, MARTIN ARAMIS

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHOKKA, SUDHAKAR RAO

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LAMBRIDIS, DEAN

Address Not Disclosed

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: OKTANYAN, HAMBIK

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: GALSTYAN, MARTIN ARAMIS

License/Registration Type: Dentist License

License Number: 61923 Primary Status: Current - Active

Address :
PO BOX 909
GLENDALE CA 91209
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: 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: CHOKKA, SUDHAKAR RAO

License/Registration Type: Dentist License

License Number: 41376 Primary Status: Current - Active

Address :
27949 Greenspot Rd
Ste. H
HIGHLAND CA 92346-4443
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: LAMBRIDIS, DEAN

License/Registration Type: Dentist License

License Number: 51199 Primary Status: Current - Active

Address :
30831 MARSEILLE WAY
WESTLAKE VILLAGE CA 91362
VENTURA 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: OKTANYAN, HAMBIK

License/Registration Type: Dentist License

License Number: 52096 Primary Status: Current - Active

Address :
2220 Foothill Blvd Ste A
LA CANADA FLINTRIDGE CA 91011-1413
LOS ANGELES COUNTY

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