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Licensing details for: 20657

Name: Mission Viejo Modern Dentistry, Dental Group of Mission Viejo Modern Dentistry, Prof. Corp.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

23962 Alicia Pkwy, Suite F106
MISSION VIEJO CA 92691
ORANGE county
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Issuance Date

May 18, 2026

Expiration Date

May 31, 2028

Current Date / Time

June 5, 2026
8:22:04 PM

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: PANDHOH, SUMEET SWAROOP

License/Registration Type: Dentist License

License Number: 51507 Primary Status: Current - Active

Address :
45 Auto Center Dr
Suite 110
FOOTHILL RANCH CA 92610-2848
ORANGE 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: ZOKAEIAN, SEYEDEH GOLNAZ

License/Registration Type: Dentist License

License Number: 100702 Primary Status: Current - Active

Address :
23962 Alicia Pkwy
MISSION VIEJO CA 92691-3940

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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: DHAMA, DEEPIKA S

License/Registration Type: Dentist License

License Number: 49044 Primary Status: Current - Active

Address :
2044 California Ave
CORONA CA 92881-3300
RIVERSIDE 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: SHETTY, SWATI

License/Registration Type: Dentist License

License Number: 50587 Primary Status: Current - Active

Address :
17160 Colima Rd Ste C-1
HACIENDA HEIGHTS CA 91745-6785
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: KANSAGRA, BINDU B

License/Registration Type: Dentist License

License Number: 57691 Primary Status: Current - Active

Address :
14415 Culver Dr
IRVINE CA 92604-0305
ORANGE COUNTY

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