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Licensing details for: 14062

Name: DENTISTS OF ANAHEIM HILLS DENTAL GROUP, LATSHIKYAN DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

8162 E SANTA ANA CANYON RD STE 104
ANAHEIM CA 92808
ORANGE county
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Practice Location

8162 E SANTA ANA CANYON RD STE 104
ANAHEIM CA 92808
ORANGE county
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Issuance Date

February 23, 2018

Expiration Date

March 31, 2027

Current Date / Time

September 8, 2026
11:01:35 AM

License Relationships

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: LATSHIKYAN, ELMIRA AMY

License/Registration Type: Dentist License

License Number: 64596 Primary Status: Current - Active

Address :
130 S Main St
Suite A-D
ORANGE CA 92868-2869
ORANGE 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: NGUYEN, BACH XUAN

License/Registration Type: Dentist License

License Number: 49784 Primary Status: Current - Active

Address :
13528 Lakewood Blv
BELLFLOWER CA 90706

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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: LE, VICTORIA NGUYEN

License/Registration Type: Dentist License

License Number: 59604 Primary Status: Current - Active

Address :
1905 Calle Barcelona
#206
CARLSBAD CA 92009-8450

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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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
30592 Santa Margarita Prkwy
Ste. D
RANCHO SANTA MARGARI CA 92688
ORANGE COUNTY

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