Blackhawk Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLACKHAWK DENTAL

Practice address

10304 Blackhawk Blvd Ste a
Houston, TX 77089-2798

Phone

(817) 727-1129

NPI assigned

Jan 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Nguyen, DMD

Title

Dentist

Phone

(817) 727-1129

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1427566496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 BLACKHAWK BLVD STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770892798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10304 BLACKHAWK BLVD STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770892798",
            "telephone_number": "817-727-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKHAWK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "817-727-1129",
        "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": []
}

• Payton Blackburn, MD
• Savannah Blackburn
• Spiros Lee Blackburn, M.D.
• Blackbyrd the Carrier Company
• Blackcar Medical
• Jerry Blacklock, M.D.
• Jasmine Janay Blackman, MBA
• Brittany Blackmon Fenwick, PH.D.
• Ana Blackmon, M.D.
• Brandy Michelle Blackmon

• Dental Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.