Dental Board of California
Licensing details for: 5107
Name: RANCHO CALIFORNIA DENTAL GROUP, BAKER, SHARIATI &
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
29645 RANCHO CALIFORNIA RD
STE 237
TEMECULA CA 92390
RIVERSIDE county
Map
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: BAKER, BRUCE BAKHSHI
License/Registration Type: Dentist License
License Number: 32267 Primary Status: Voluntary Surrendered
Address :
PO BOX 669
POWAY CA 92074
SAN DIEGO COUNTY
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: FARAJZADEH, EDWARD
License/Registration Type: Dentist License
License Number: 33031 Primary Status: Current - Active
Address :
13983 Mango Dr
106
DEL MAR CA 92014-3131
SAN DIEGO COUNTY
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: SHARIATI, MANSOUR
License/Registration Type: Dentist License
License Number: 51186 Primary Status: Deceased
Address :
16756 SANTA CORINA CT
SAN DIEGO CA 92127
SAN DIEGO COUNTY
