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Licensing details for: 5181

Name: SMILE DESIGNS OF ROCKLIN, DENTAL OFFICE OF

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

6000 FAIRWAY, STE 18
ROCKLIN CA 95677
PLACER county
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Issuance Date

September 9, 2004

Expiration Date

May 31, 2011

Current Date / Time

June 6, 2025
1:35:11 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KHODAI, SHAHRAM

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KAHBODY, TARANEH

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: KHODAI, SHAHRAM

License/Registration Type: Dentist License

License Number: 43027 Primary Status: Current - Active

Address :
3517 Marconi Ave #105
SACRAMENTO CA 95821
SACRAMENTO 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: KAHBODY, TARANEH

License/Registration Type: Dentist License

License Number: 42058 Primary Status: Current - Active

Address :
4690 Natomas Blvd
Ste 100
SACRAMENTO CA 95835-2230
SACRAMENTO COUNTY

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