Byron H. Black, DDS, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

BYRON H. BLACK, DDS, PLLC

Practice address

102 Memorial Dr
Ripley, WV 25271-1164

Phone

(304) 514-5500

Fax

(304) 514-5504

NPI assigned

Sep 29, 2014

Last updated

Aug 5, 2022By 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

Mrs. Renee L. Johnson, RN-BSN

Title

Clinical Practice Manager

Phone

(304) 514-5500

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Byron Hal Black, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Ripley, WV
  • NPI 1528041399
  NPD

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1841693355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MEMORIAL DRIVE",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252710717",
            "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": "1215 Virginia St E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253012908",
            "country_code": "US",
            "telephone_number": "304-514-5500",
            "fax_number": "304-514-5504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BYRON H. BLACK, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CLINICAL PRACTICE MANAGER",
        "authorized_official_telephone_number": "304-514-5500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN-BSN"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "2081",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Burke, PHARMD
• Paul Burke, MD
• Kelly Butcher
• Tabitha Butcher, FNP
• Che Butler
• Cierra Carpenter
• Caleb Timothy Cart, OD
• Allison Cartmill
• Deborah Ann Casdorph, FNP
• Crystal Castelli

• 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 Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.