NPIMap

Organization Active NPI

Edward E Black DDS,Ms,Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
National Provider Identifier
1508010497
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
17879 Issued in CA
Legal business name
EDWARD E BLACK DDS,MS,INC
Practice address
3015 Crenshaw Blvd
Suite C
Los Angeles, CA 90016-4264
Phone
(323) 734-1534
Fax
(323) 734-4693
NPI assigned
Nov 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Authorized official

Name
Maria Orellana
Title
Office Manager
Phone
(323) 734-1534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 17879 CA Primary

Addresses

Primary practice location

3015 Crenshaw Blvd
Suite C
Los Angeles, CA 90016-4264

Mailing address

3015 Crenshaw Blvd
Suite C
Los Angeles, CA 90016-4264
Phone (323) 734-1534

National Provider Directory

National Provider Directory
Tax ID family
Edward E Black Ddsmsinc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3015 Crenshaw Blvd
Ste C
Los Angeles, CA 90016
Phone (323) 734-1534

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1508010497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 CRENSHAW BLVD",
            "address_2": "SUITE C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164264",
            "telephone_number": "323-734-1534",
            "fax_number": "323-734-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 CRENSHAW BLVD",
            "address_2": "SUITE C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164264",
            "telephone_number": "323-734-1534",
            "fax_number": "323-734-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD E BLACK DDS,MS,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "ORELLANA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "323-734-1534"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "17879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.