William Michael Black, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.033082 Issued in IL

Practice address

2316 W Madison St Ste 2228
Chicago, IL 60612-2228

Phone

(312) 491-0601

NPI assigned

Jun 15, 2021

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• William Black DMD, P.C.

  dba Sakura Dental

  • General Practice Dentistry
  • Wilmette, IL
  • NPI 1245930395
  NPD Authorized official

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1083282107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 W IRVING PARK RD APT 1E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183326",
            "telephone_number": "847-421-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 W MADISON ST STE 2228",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122228",
            "telephone_number": "312-491-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Black, MA CCC-SLP/L
• Sandra Juel Black, L.M.T.
• Stephanie R Black, M.D.
• Terese Marie Black, D.C.
• Vonisha Lashawn Black, PMHNP-BC APRN MSN RN
• Amy Meredith Blackburn, M.D.
• Anna M Blackburn, LCSW
• Joanna S Blackburn, MD
• Tracee A Blackburn, PA-C
• Bruce A Blacker, M.D.

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.