Individual provider Active NPI

Sina Behmanesh

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1447673298
Registry record updated Dec 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
154457 Issued in MD
Practice address
1727 Gorsuch Ave
Baltimore, MD 21218-4927
Phone
(443) 410-4548
NPI assigned
Jan 30, 2014
Last updated
Dec 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401414213 VA
General Practice Dentistry 1223G0001X 154457 MD Primary

Addresses

Primary practice location

1727 Gorsuch Ave
Baltimore, MD 21218-4927

Mailing address

1727 Gorsuch Ave
Baltimore, MD 21218-4927
Phone (443) 410-4548

Other practice location 1

1011 E Patrick St
Frederick, MD 21701-3119
Phone (703) 728-8572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
154457MDMDGeneral Practice Dentistry
0401414213VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sinazara Group LLC General Practice CurrentSince Mar 3, 2024 Accepting new patients
Sinazara Group LLC General Practice CurrentSince Dec 28, 2022 Accepting new patients

Locations

1727 Gorsuch Ave
Baltimore, MD 21218
Phone (443) 410-4548

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670716800000",
    "number": "1447673298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 GORSUCH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184927",
            "telephone_number": "443-410-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 GORSUCH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184927",
            "telephone_number": "443-410-4548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 E Patrick St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217013119",
            "country_code": "US",
            "telephone_number": "703-728-8572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEHMANESH",
        "first_name": "SINA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2022-12-11",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414213",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "154457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.