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Licensing details for: 15575

Name: NEWPORT DENTAL, A DENTAL OFFICE OF SAHAWNEH DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

3635 E. FIRST ST
LOS ANGELES CA 90063
LOS ANGELES county
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Practice Location

3635 E. FIRST ST
LOS ANGELES CA 90063
LOS ANGELES county
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Issuance Date

December 19, 2019

Expiration Date

December 31, 2025

Current Date / Time

June 7, 2025
7:10:1 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SAHAWNEH, SHOROUQ SAMEER

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: SAHAWNEH, SHOROUQ SAMEER

License/Registration Type: Dentist License

License Number: 55643 Primary Status: Current - Active

Address :
2300 Harbor Blvd.
Suite H5
COSTA MESA CA 92626
ORANGE COUNTY

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