Active NPI
Richard Michael Black, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Encinitas, CA
National Provider Identifier
1316124555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 29211
- Practice address
- 317 N El Camino Real
Suite 203
Encinitas, CA 92024-2811 - Phone
- (760) 942-4040
- Fax
- (760) 918-6890
- NPI assigned
- Jan 30, 2008
- Last updated
- Jan 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 29211 | CA | Primary |
Addresses
Primary practice location
317 N El Camino Real
Suite 203
Encinitas, CA 92024-2811
Mailing address
317 N El Camino Real
Suite 203
Encinitas, CA 92024-2811
Phone (760) 942-4040
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 |
|---|---|---|---|
| 29211 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201651200000",
"number": "1316124555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 N EL CAMINO REAL",
"address_2": "SUITE 203",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920242811",
"telephone_number": "760-942-4040",
"fax_number": "760-918-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 N EL CAMINO REAL",
"address_2": "SUITE 203",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920242811",
"telephone_number": "760-942-4040",
"fax_number": "760-918-6890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "RICHARD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-30",
"last_updated": "2008-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "29211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.