Hattie L. Thorn-Black, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D8307 Issued in MN

Practice address

1315 E 24TH St
Minneapolis, MN 55404-3975

Phone

(612) 721-9825

Fax

(612) 721-2904

NPI assigned

Jun 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1215933486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043975",
            "telephone_number": "612-721-9825",
            "fax_number": "612-721-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043975",
            "telephone_number": "612-721-9825",
            "fax_number": "612-721-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORN-BLACK",
        "first_name": "HATTIE",
        "middle_name": "L.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D8307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942317600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Thoresen, MA, LMFT
• Andrew Joseph Thoreson, PHARMD
• Jennifer Amy Thoreson, OTR/L
• Dorothy Ann Thorman, LICSW
• Kathleen Thormodsgaard
• Melissa Rose Thorne, RDH
• Susan Louise Thornton, MA,LP
• Edinatu Thoronka
• Deborah Thorp
• Michael Thorp, M.D.

• Dentist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.