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Licensing details for: 8120

Name: BERRYESSA DENTAL SPA, DENTAL OFFICE OF ASHMITA SHETTY, DDS.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Previous Names: BERRYESSA DENTAL SPA

Address of Record

2664 BERRYESSA ROAD
STE. 104
SAN JOSE CA 95132
SANTA CLARA county
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Practice Location

2664 BERRYESSA ROAD
STE. 104
SAN JOSE CA 95132
SANTA CLARA county
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Issuance Date

May 5, 2009

Expiration Date

July 31, 2017

Current Date / Time

June 6, 2025
2:5:9 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SHETTY, ASHMITA

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: SHETTY, ASHMITA

License/Registration Type: Dentist License

License Number: 46683 Primary Status: Current - Active

Address :
2664 BERRYESSA RD. SUITE 104
SAN JOSE CA 95132
SANTA CLARA COUNTY

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