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Licensing details for: 18076

Name: WEST COAST DENTAL & ORTHODONTICS, ADULT & KIDS DENTAL GROUP DENTAL OFFICE OF MANAVI DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

4176 PYRITE STREET BUILDING #10
JURUPA VALLEY CA 92569
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Practice Location

4176 PYRITE STREET BUILDING #10
JURUPA VALLEY CA 92569
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Issuance Date

September 5, 2023

Expiration Date

March 31, 2025

Current Date / Time

April 3, 2026
12:38:28 AM

License Relationships

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: SAREH, ATEFEH

License/Registration Type: Dentist License

License Number: 41993 Primary Status: Current - Active

Address :
12121 Wilshire Blvd
Suite 1111
LOS ANGELES CA 90025-1123
LOS ANGELES 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: MANAVI, FARHAD

License/Registration Type: Dentist License

License Number: 38558 Primary Status: Current - Active

Address :
4149 TWEEDY BLVD STE G
SOUTH GATE CA 90280
LOS ANGELES COUNTY

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