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Licensing details for: 17256

Name: MIRA MESA SMILES DENTISTRY DENTAL GROUP, BAYDOUN DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

8997 MIRA MESA BLVD
SAN DIEGO CA 92126
SAN DIEGO county
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Practice Location

8997 MIRA MESA BLVD
SAN DIEGO CA 92126
SAN DIEGO county
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Issuance Date

August 3, 2022

Expiration Date

October 31, 2025

Current Date / Time

June 6, 2025
1:31:58 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BAYDOUN, ALIA HAMDAN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LE, VICTORIA NGUYEN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ALVARADO, STEVEN CHRISTOPHER

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ARIANNEJAD, BABAK

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: BAYDOUN, ALIA HAMDAN

License/Registration Type: Dentist License

License Number: 102595 Primary Status: Current - Active

Address :
8997 Mira Mesa Blvd
SAN DIEGO CA 92126-2738
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: ALVARADO, STEVEN Christopher

License/Registration Type: Dentist License

License Number: 59267 Primary Status: Current - Active

Address :
4640 Cass St Unit 9720
SAN DIEGO CA 92109-2804
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: 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: 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: 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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