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Licensing details for: 15143

Name: LA COSTA DENTISTRY DENTAL GROUP MOBASHER AND NOSTI DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

7625 VIA CAMPANILE, SUITE 130
CARLSBAD CA 92009
SAN DIEGO county
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Practice Location

7625 VIA CAMPANILE, SUITE 130
CARLSBAD CA 92009
SAN DIEGO county
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Issuance Date

July 19, 2019

Expiration Date

April 30, 2023

Current Date / Time

June 6, 2025
1:58:6 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NOSTI, JOHN CHARLES

Address Not Disclosed

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: MOBASHER, NEDA

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PHAM, MINH BAO

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: NOSTI, JOHN CHARLES

License/Registration Type: Dentist License

License Number: 48655 Primary Status: Current - Active

Address :
709 Center Dr Ste 101
SAN MARCOS CA 92069-2502
SAN DIEGO 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: MOBASHER, NEDA

License/Registration Type: Dentist License

License Number: 59381 Primary Status: Current - Active

Address :
1534 Encinitas Blvd
ENCINITAS CA 92024-2932
SAN DIEGO 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: PHAM, MINH BAO

License/Registration Type: Dentist License

License Number: 46321 Primary Status: Expired

Address :
5675 Balboa Ave
SAN DIEGO CA 92111-2705
SAN DIEGO 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: 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

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