Anthony J. Black, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410749 Issued in VA

Practice address

12950 Highland Crossing Dr
Suite F
Herndon, VA 20171-5888

Phone

(703) 787-9670

NPI assigned

May 3, 2007

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

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 Aug 8, 2017 through Aug 8, 2027

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.

• Loudoun Family and Cosmetic Dentistry

  • Dentist
  • Leesburg, VA
  • NPI 1962821496
  NPD (past)
• Skinner Ossakow & Associates

  • Dentist
  • Leesburg, VA
  • NPI 1740413830
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1992927115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12950 HIGHLAND CROSSING DR",
            "address_2": "SUITE F",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715888",
            "telephone_number": "703-787-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 HIGHLAND CROSSING DR",
            "address_2": "SUITE F",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715888",
            "telephone_number": "703-787-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ANTHONY",
        "middle_name": "J.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BH Brightview Holdings Innovation Center TRS Opco, LLC
• Natasha Bharucha, DDS
• Ami Bhavsar
• Anne Bielamowicz, MD
• Big Heart ABA Virginia LLC
• Angelly Blanco Gonzalez
• Jennifer Blanding, PA-C
• Shannon Bloch, DC
• Victoria Block, PT
• Bloom Home Care LLC

• General Practice Dentistry in Herndon, VA
• Providers in Herndon, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.