NPIMap

Organization Active NPI

Corey Black DMD PLLC

  • Dental Clinic/Center
  • New York, NY
National Provider Identifier
1043991342
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
COREY BLACK DMD PLLC
Doing business as
SmileSpace Harlem
Practice address
40 W 117TH St
New York, NY 10026-1921
Phone
(347) 315-3633
NPI assigned
Jul 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Dr. Corey Lavelle Black, DMDNPI 1952839318
Title
Owner
Phone
(717) 395-3144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

40 W 117TH St
New York, NY 10026-1921

Mailing address

40 W 117TH St
New York, NY 10026-1921
Phone (347) 315-3633

Other names 1

  • SmileSpace Harlem Doing business as

National Provider Directory

National Provider Directory

Locations

40 W 117th St
New York, NY 10026
Phone (347) 315-3633

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1043991342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W 117TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261921",
            "telephone_number": "347-315-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W 117TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261921",
            "telephone_number": "347-315-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREY BLACK DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "LAVELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-395-3144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SmileSpace Harlem",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.