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Licensing details for: 154

Name: TAHERI, SHAWN

License Type: Pediatric Minimal Sedation Permit

Primary Status: Current - Active

Previous Names: TAHERI, SHAHRAM

Address of Record

704 BLOSSOM HILL RD SUITE 104
SAN JOSE CA 95123
SANTA CLARA county
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Practice Location

704 BLOSSOM HILL RD SUITE 104
SAN JOSE CA 95123
SANTA CLARA county
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Issuance Date

September 22, 2023

Expiration Date

November 30, 2025

Current Date / Time

June 6, 2025
2:8:16 AM

License Relationships

PMS to DDS or OMS or SP

License/Registration Role: Pediatric Minimal Sedation Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: TAHERI, SHAWN

License/Registration Type: Dentist License

License Number: 43736 Primary Status: Current - Active

Address :
704 Blossom Hill Rd, Suite 104
SAN JOSE CA 95123
SANTA CLARA COUNTY

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