Anthony J. Black, D.D.S,,P.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410749 Issued in VA

Legal business name

ANTHONY J. BLACK, D.D.S,,P.C

Practice address

12950 Highland Crossing Dr
Suite F
Herndon, VA 20171-5888

Phone

(703) 787-9670

NPI assigned

Aug 6, 2008

Last updated

Aug 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Joseph BlackNPI 1992927115

Title

Owner Dentist

Phone

(703) 795-8362

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony J. Black, D.D.S.

  • General Practice Dentistry
  • Herndon, VA
  • NPI 1992927115
  Authorized official Same address or phone

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1568628857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 WOODY LN",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220662024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 HIGHLAND CROSSING DR",
            "address_2": "SUITE F",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715888",
            "telephone_number": "703-787-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY J. BLACK, D.D.S,,P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "703-795-8362",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Herndon, VA
• Providers in Herndon, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.