Individual ProviderSina BanankhahDentistDental ProvidersPractice Address263 Farmington Ave, Farmington, CT 06030-0001(860) 679-2000(323) 287-7837PECOS EnrollmentBased on the most recent information from CMS, provider Sina Banankhah does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1437685781Provider TypeIndividualFull NameBanankhah, SinaGenderMaleSole ProprietorNoEnumeration Date5/5/2017Last Updated9/10/2024Contact InformationPractice LocationPractice Address263 Farmington Ave, Farmington, CT 06030-0001Phone(860) 679-2000FaxUnlisted FaxMailing LocationMailing Address130 S Mentor Ave Unit 201, Pasadena, CA 91106-2943Phone(323) 287-7837FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223X0400XPrimaryDescriptionDentistDental ProvidersLicenseDDS104655CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer