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Licensing details for: 19000

Name: BIXBY ENDODONTICS DENTAL GROUP OF NEDJAT-HAIEM DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

612 E. CARSON ST.
LONG BEACH CA 90807
LOS ANGELES county
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Practice Location

612 E. CARSON ST.
LONG BEACH CA 90807
LOS ANGELES county
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Issuance Date

October 15, 2024

Expiration Date

December 31, 2026

Current Date / Time

June 6, 2025
6:40:15 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NEDJAT-HAIEM, MICHAEL

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: NEDJAT-HAIEM, MICHAEL

License/Registration Type: Dentist License

License Number: 106258 Primary Status: Current - Active

Address :
1901 Solar Dr
250
OXNARD CA 93036-2641

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