NPIMap

Organization Active NPI

Richard Anthony, DDS Ms, a Prof. Corp.

Doing business as Blackhawk Orthodontics, Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Danville, CA
National Provider Identifier
1790883023
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
34025 Issued in CA
Legal business name
RICHARD ANTHONY, DDS MS, A PROF. CORP.
Doing business as
Blackhawk Orthodontics, Inc
Practice address
4165 Blackhawk Plaza Cir
Suite 260
Danville, CA 94506-4904
Phone
(925) 736-3311
Fax
(925) 736-3313
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard J Anthony, D.D.S., M.S.NPI 1912771502
Title
President
Phone
(925) 736-3311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 34025 CA Primary

Addresses

Primary practice location

4165 Blackhawk Plaza Cir
Suite 260
Danville, CA 94506-4904

Mailing address

4165 Blackhawk Plaza Cir
Suite 260
Danville, CA 94506-4904
Phone (925) 736-3311

Other identifiers 1

IdentifierTypeStateIssuer
180515OtherCACIGNA PROVIDER NUMBER

Other names 1

  • Blackhawk Orthodontics, Inc Doing business as

National Provider Directory

National Provider Directory

Locations

4165 Blackhawk Plaza Cir
Ste 260
Danville, CA 94506
Phone (925) 736-3311

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790883023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR",
            "address_2": "SUITE 260",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064904",
            "telephone_number": "925-736-3311",
            "fax_number": "925-736-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR",
            "address_2": "SUITE 260",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064904",
            "telephone_number": "925-736-3311",
            "fax_number": "925-736-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD ANTHONY, DDS MS, A PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-736-3311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "34025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "180515",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackhawk Orthodontics, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.