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Licensing details for: 353

Name: FAELDAN-SUAREZ, MARISSA VALMONTE

License Type: Pediatric Minimal Sedation Permit

Primary Status: Current - Active

Previous Names: FAELDAN, MARISSA VALMONTE FAELDAN-SUAREZ, MARISSA

Address of Record

5432 Sepulveda Blvd
Suite B
CULVER CITY CA 90230-5512
LOS ANGELES county
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Issuance Date

September 17, 2024

Expiration Date

September 30, 2026

Current Date / Time

June 6, 2025
1:53:48 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: COCO LANE ORTHODONTICS DENTAL GROUP OF MARISSA FAELDAN-SUAREZ, DDS

License/Registration Type: Fictitious Name Permit

License Number: 18840 Primary Status: Current - Active

Address :
5432 SEPULVEDA BLVD. SUITE B
CULVER CITY CA 90230
LOS ANGELES COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: SMILE STREET PEDIATRIC DENTISTRY, DENTAL GROUP OF MARISSA FAELDAN

License/Registration Type: Fictitious Name Permit

License Number: 10573 Primary Status: Current - Active

Address :
5432 SEPULVEDA BOULEVARD, STE. B
CULVER CITY CA 90230
LOS ANGELES COUNTY

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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: FAELDAN-SUAREZ, MARISSA VALMONTE

License/Registration Type: Dentist License

License Number: 58944 Primary Status: Current - Active

Address :
5432 Sepulveda Blvd
B
B
CULVER CITY CA 90230-5512
LOS ANGELES COUNTY

Map

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