Dental Board of California
Licensing details for: 13793
Name: FIRST STREET DENTAL GROUP, SETAREH SHENAS DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
License Relationships
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: SETAREH, KATAYOUN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GHAZAL, CAROLYN G
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ELIE, ARASH
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: 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
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: GHAZAL, CAROLYN G
License/Registration Type: Dentist License
License Number: 38682 Primary Status: Current - Active
Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
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: ELIE, ARASH
License/Registration Type: Dentist License
License Number: 47470 Primary Status: Current - Active
Address :
15740 GREENLEAF STREET
ENCINO CA 91436
LOS ANGELES 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: SETAREH, KATAYOUN
License/Registration Type: Dentist License
License Number: 50822 Primary Status: Current - Active
Address :
18519 Devonshire St
NORTHRIDGE CA 91324-1308
