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Licensing details for: 18196

Name: WYNNING SMILES DENTISTRY DENTAL OFFICE OF SHANG DMD DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Sole Owner

Address of Record

21222 BEACH BLVD
HUNTINGTON BEACH CA 92648-5411
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Practice Location

21222 BEACH BLVD
HUNTINGTON BEACH CA 92648-5411
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Issuance Date

October 19, 2023

Expiration Date

May 31, 2024

Current Date / Time

June 6, 2025
2:1:20 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SHANG, WYNN

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: SHANG, WYNN

License/Registration Type: Dentist License

License Number: 103456 Primary Status: Current - Active

Address :
13234 Jamboree Rd
IRVINE CA 92602-2307
ORANGE COUNTY

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