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Licensing details for: 17599

Name: KIND DENTAL OF LA MESA DENTAL OFFICE OF DR. MAYSAM SALEHPOUR

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

5153 JACKSON DRIVE
LA MESA CA 91942
SAN DIEGO county
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Practice Location

5153 JACKSON DRIVE
LA MESA CA 91942
SAN DIEGO county
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Issuance Date

January 4, 2023

Expiration Date

October 31, 2023

Current Date / Time

June 7, 2025
4:6:27 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SALEHPOUR, MAYSAM MAGID

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: SALEHPOUR, MAYSAM MAGID

License/Registration Type: Dentist License

License Number: 61527 Primary Status: Current - Active

Address :
5153 JACKSON DRIVE
LA MESA CA 91942
SAN DIEGO COUNTY

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