David Walton Black, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21350 Issued in CA

Practice address

4736 Scotts Valley Dr Ste C
Scotts Valley, CA 95066-4226

Phone

(831) 438-0554

Fax

(831) 438-8548

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508940032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4736 SCOTTS VALLEY DR STE C",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664226",
            "telephone_number": "831-438-0554",
            "fax_number": "831-438-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 SCOTTS VALLEY DR STE C",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664226",
            "telephone_number": "831-438-0554",
            "fax_number": "831-438-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DAVID",
        "middle_name": "WALTON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "21350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher James Bernardi, D.O.
• Devin Bernhardt
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• Beyond Prosthetics Inc
• Jeannette Bingham, NP
• Leslie C Black, M.S.,CCC/SLP
• Stacy Blasi, LCSW
• BLC Oak Tree Villa, Inc.
• Jean Blevins
• Cassia Lea Bloom, LMFT

• General Practice Dentistry in Scotts Valley, CA
• Providers in Scotts Valley, 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 Jul 8, 2007; 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.