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Licensing details for: 15191

Name: BERNARDO HEIGHTS DENTAL GROUP, PIRASTEHFAR AND HABASHI DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

15731 BERNARDO HEIGHTS PKWY., SUITE 101
SAN DIEGO CA 92128
SAN DIEGO county
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Practice Location

15731 BERNARDO HEIGHTS PKWY., SUITE 101
SAN DIEGO CA 92128
SAN DIEGO county
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Issuance Date

July 30, 2019

Expiration Date

April 30, 2027

Current Date / Time

June 6, 2025
9:6:18 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WATANABE, BRYAN KAZUMI

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PHAM, MINH BAO

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PIRASTEHFAR, KAMRAN WILLIAM

Address Not Disclosed

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: HABASHI, AFSHIN

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: HABASHI, AFSHIN

License/Registration Type: Dentist License

License Number: 43789 Primary Status: Current - Active

Address :
6101 Mission Gorge Rd
SAN DIEGO CA 92120-3401
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: 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: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE 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: PIRASTEHFAR, KAMRAN WILLIAM

License/Registration Type: Dentist License

License Number: 64913 Primary Status: Current - Active

Address :
15731 Bernardo Heights Pkwy
SUITE 101
SAN DIEGO CA 92128-3156
SAN DIEGO COUNTY

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