Brian Scott Black, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25509 Issued in TX

Practice address

219 Rock Prairie Rd
Ste. 100
College Station, TX 77845-8796

Phone

(979) 695-8000

Fax

(979) 314-9702

NPI assigned

Jun 11, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 4, 2016 through Mar 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Brazos Valley Dental Group, LLC

  • Dental Clinic/Center
  • College Station, TX
  • NPI 1306557871
  NPD Authorized official
• Bryan Dental Group PLLC

  • General Practice Dentistry
  • Bryan, TX
  • NPI 1851147367
  NPD Authorized official
• Brian S Black DDS PLLC

  • General Practice Dentistry
  • College Station, TX
  • NPI 1619277894
  NPD (past) Authorized official

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1891015996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "HEMPSTEAD",
            "state": "TX",
            "postal_code": "774450095",
            "telephone_number": "832-675-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 ROCK PRAIRIE RD",
            "address_2": "STE. 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458796",
            "telephone_number": "979-695-8000",
            "fax_number": "979-314-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sameer Bilal, DDS
• Paul David Rocky Bilhartz, M.D., M.B.A.
• Rebecca Bischoff
• Valerie Lee Bivona, CRNA
• Brent T. Black, DDS
• Jamilia Blake, PH.D.
• Aniki Blanchard, LCDC
• Jennifer J Blasingame, M.D.
• Alexandra Blazek
• Britney Bledsoe, LMSW

• General Practice Dentistry in College Station, TX
• Providers in College Station, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.