Corey L Black, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

059870 Issued in NY

Practice address

1035 Fulton St Ste 1
Brooklyn, NY 11238-5276

Phone

(347) 391-4279

NPI assigned

May 30, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• BK Smiling Dentistry PLLC

  • Dental Clinic/Center
  • Brooklyn, NY
  • NPI 1487288601
  NPD Authorized official
• Corey Black DMD PLLC

  • Dental Clinic/Center
  • New York, NY
  • NPI 1043991342
  NPD Authorized official

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1952839318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 FULTON ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385276",
            "telephone_number": "347-391-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 FULTON ST STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385276",
            "telephone_number": "347-391-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "COREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059870",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Star RX Inc.
• Rachel Black-Kutner
• Alexander Irving Black
• Andrew D Black, M.D
• Christopher Dopico Black
• Ivelisa Black
• Jamia Black
• Jasmine Black
• Julie Black, PA-C
• Kadian Black, RN

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.