James T. Black, DDS a Professional Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17880 Issued in CA

Legal business name

JAMES T. BLACK, DDS A PROFESSIONAL DENTAL CORPORATION

Doing business as

DBA Crenshaw Professional Dental Center

Practice address

3015 Crenshaw Blvd
Los Angeles, CA 90016-4264

Phone

(323) 731-0801

Fax

(323) 731-1351

NPI assigned

Feb 2, 2007

Last updated

Apr 11, 2017By 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

Ms. Jeanine T Black

Title

Business Administrator

Phone

(323) 731-0801

Specialties & licenses 1

Addresses

Other names 1

• DBA Crenshaw Professional Dental Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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.

• James Tillman Black Jr., DDS

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1801092648
  Medicare reassignment NPD
• Debbie Renee Ballenger, DDS

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1346447018
  NPD (past)
• Robert Johnson, DDS

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1366637704
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1871631622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164264",
            "telephone_number": "323-731-0801",
            "fax_number": "323-731-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164264",
            "telephone_number": "323-731-0801",
            "fax_number": "323-731-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES T. BLACK, DDS A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "323-731-0801",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "17880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Crenshaw Professional Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Mobaser DDS Inc (Silverlake Dental)
• James O. Eze (Oranto medical supplies)
• James R. Katz, M.D., Inc.
• James Song Pharm.D. Pharmacy Inc. (Serrano Medical Pharmacy)
• James T Scott MD a Professional Corporation
• James T. Long, M.D., PH.D., Inc.
• James Y. Wang, MD, Inc. (Metropolis Dermatology)
• Brenda Joyce James-Johnson, CAS,RAS
• Kathryn James-Jolly
• Aaryn James

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.