Stephen J Black, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

13600 Issued in MA

Practice address

288 Belmont Street
Brockton, MA 02301

Phone

(508) 583-0103

Fax

(508) 583-0140

NPI assigned

Mar 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in MA

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.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John P Blatz Jr DDS PC

  dba Massasoit Dental Associates

  • Dentist
  • Brockton, MA
  • NPI 1053431361
  NPD (past)
• Matthew Manzi DMD PC

  dba Massasoit Dental Associates

  • Dentist
  • Brockton, MA
  • NPI 1063015816
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942320254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 BELMONT STREET",
            "address_2": "MASSASOIT DENTAL ASSOCIATES",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-583-0103",
            "fax_number": "508-583-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 BELMONT STREET",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-583-0103",
            "fax_number": "508-583-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "13600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jeanne Bingham-Maas, M.A.CCC-SLP
• Bio-Medical Applications of Massachusetts, Inc. (Brockton Dialysis Center)
• Jessica Lee Bishop
• Laura Elizabeth Bishop
• Lorie Bixler
• Judith Blaikie
• Laura R Blakey
• Kyonie Sephaina Blanc
• Jennifer Blanchard, BA
• Scott D Blanchard, MD

• Dentist in Brockton, MA
• Providers in Brockton, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.