Byron Hal Black, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2081 Issued in WV

Practice address

102 Memorial Dr
Ripley, WV 25271-1164

Phone

(304) 514-5500

Fax

(304) 514-5504

NPI assigned

Nov 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Byron H. Black, DDS, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Ripley, WV
  • NPI 1841693355
  NPD
• DRS Brock, Henderson, Di Prisco, Ravelo and Green Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Beckley, WV
  • NPI 1194364398
  NPD (past)
• DRS Brock, Henderson, Di Prisco, Ravelo and Green Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Hurricane, WV
  • NPI 1992766737
  NPD (past)

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1528041399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MEMORIAL DR",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "25271",
            "telephone_number": "304-514-5500",
            "fax_number": "304-514-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MEMORIAL DR",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252711164",
            "telephone_number": "304-514-5500",
            "fax_number": "304-514-5504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1218 Virginia Street East",
            "address_2": "Suite D",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "25301",
            "country_code": "US",
            "telephone_number": "304-514-5500",
            "fax_number": "304-514-5504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BYRON",
        "middle_name": "HAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "2081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138164000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Bennett- Eddy
• Brandon Bentley
• Nikola Bicak
• Jimella Jane Bigley
• Bio-Medical Applications of West Virginia, Inc.
• Amanda Blankenship
• Blue Rose Holistics, LLC
• Elizabeth A Boggess
• Linda Boggess
• Victoria Boldman, FNP-C

• Oral and Maxillofacial Surgery (Dentist) in Ripley, WV
• Providers in Ripley, WV by specialty
• Oral and Maxillofacial Surgery (Dentist) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.