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Licensing details for: 16157

Name: PROMENADE DENTISTS DENTAL GROUP, AKBARI FARAHANI AND MERCER DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2710 VIA DE LA VALLE., SUITE B250
DEL MAR CA 92014
SAN DIEGO county
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Practice Location

2710 VIA DE LA VALLE., SUITE B250
DEL MAR CA 92014
SAN DIEGO county
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Issuance Date

December 1, 2020

Expiration Date

May 31, 2024

Current Date / Time

June 6, 2025
9:59:51 PM

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: ARIANNEJAD, BABAK

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MERCER, JUSTIN WILLIAM

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: AKBARI FARAHANI, ANAHITA

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: MERCER, JUSTIN WILLIAM

License/Registration Type: Dentist License

License Number: 59375 Primary Status: Current - Active

Address :
3150 Case Rd Bldg C
PERRIS CA 92570-5552
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: 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: AKBARI FARAHANI, ANAHITA

License/Registration Type: Dentist License

License Number: 101304 Primary Status: Current - Active

Address :
277 S. Rancho Santa Fe Rd.
Suit J
277 S Rancho Santa Fe Rd
SAN MARCOS CA 92078
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: ARIANNEJAD, BABAK

License/Registration Type: Dentist License

License Number: 59452 Primary Status: Current - Active

Address :
718 W Washington St
SAN DIEGO CA 92103-1938
SAN DIEGO COUNTY

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