William J. Black DDS, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40140 Issued in CA

Legal business name

WILLIAM J. BLACK DDS, INC

Practice address

2925 Elverta Rd
Antelope, CA 95843-9106

Phone

(916) 331-6288

Fax

(916) 331-0760

NPI assigned

Jun 17, 2010

Organization subpart

No

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

Authorized official

Name

Mr. William John Black, DDSNPI 1043251176

Title

Owner

Phone

(916) 331-6288

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• William John Black, D.D.S.

  • General Practice Dentistry
  • Antelope, CA
  • NPI 1043251176
  NPD (past) Authorized official

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1336460088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 ELVERTA RD",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958439106",
            "telephone_number": "916-331-6288",
            "fax_number": "916-331-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 ELVERTA RD",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958439106",
            "telephone_number": "916-331-6288",
            "fax_number": "916-331-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J. BLACK DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-331-6288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Antelope, CA
• Providers in Antelope, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.