Organization
SINA BANANKHAH DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SINA BANANKHAH DDS (OWNER DENTIST)
(818) 287-0910
Entity
Organization
Contact information
Practice address
12930 VENTURA BLVD STE 226B, STUDIO CITY, CA 91604-2200
(818) 287-0910
Mailing address
12930 VENTURA BLVD STE 226B, STUDIO CITY, CA 91604-2200
(818) 287-0910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDS104655
DENTAL LICENSE
CA
Enumeration date
06/21/2024
Last updated
09/07/2024
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