Active NPI
Destini Black
- Dentist
- Raleigh, NC
National Provider Identifier
1023860814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14384
- Practice address
- 1011 Rock Quarry Rd
Raleigh, NC 27610-3825 - Phone
- (919) 833-3111
- NPI assigned
- Apr 4, 2024
- Last updated
- Sep 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14384 | NC | Primary |
Addresses
Primary practice location
1011 Rock Quarry Rd
Raleigh, NC 27610-3825
Mailing address
1011 Rock Quarry Rd
Raleigh, NC 27610-3825
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14384 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756944000000",
"number": "1023860814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 ROCK QUARRY RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276103825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 ROCK QUARRY RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276103825",
"telephone_number": "919-833-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "DESTINI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-04",
"last_updated": "2025-09-04",
"certification_date": "2025-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "14384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
- BJ's Wholesale Club Inc.
- BKD Personal Assistance Services LLC (Brookdale at Home North Raleigh)
- BKD Personal Assistance Services LLC (Brookdale at Home North Raleigh (HC))
- BKSS Fitness LLC (Shreeji Clinic)
- Alexandra Black, NURSE PRACTITIONER
- Haylie Black
- Henry Campbell McNaughton Black
- Julia Black, MS
- Megan Kathleen Black, MSN, APRN, AGNP-C
- Taylor Winn Black, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.