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Licensing details for: 36

Name: YAVARI, MANSOUREH

License Type: Pediatric Minimal Sedation Permit

Primary Status: Expired Primary Status Definition

Address of Record

11435 CYPRESS CANYON PARK DRIVE
SAN DIEGO CA 92131
SAN DIEGO county
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Practice Location

909 EUCLID AVE
NATIONAL CITY CA 91950
SAN DIEGO county
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Issuance Date

February 3, 2023

Expiration Date

January 31, 2025

Current Date / Time

June 6, 2025
9:52:45 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: NEXGEN DENTISTRY DENTAL PRACTICE OF M YAVARI. DDS

License/Registration Type: Fictitious Name Permit

License Number: 15800 Primary Status: Current - Active

Address :
909 EUCLID AVE
NATIONAL CITY CA 91950
SAN DIEGO 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: YAVARI, MANSOUREH

License/Registration Type: Dentist License

License Number: 56898 Primary Status: Current - Active

Address :
11435 Cypress Canyon Park Dr
SAN DIEGO CA 92131-3520
SAN DIEGO COUNTY

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