Jerry B. Black, Dds, Pc in Salt Lake City - General Practice
Jerry B. Black, Dds, Pc - NPI 1487696704
Jerry B. Black, Dds, Pc is a General Practice in Salt Lake City, Utah. Jerry B. Black, Dds, Pc practices all healthcare services and medical treatments related to General Practice. The NPI Number for Jerry B. Black, Dds, Pc is 1487696704. The last update date is 2020-08-22.
Jerry B. Black, Dds, Pc's current location address is 1925 E 5600 S, Salt Lake City, Utah. You can contact this provider via phone number 8012780458 and fax number 8012780460. The mailing address for Jerry B. Black, Dds, Pc is 1925 E 5600 S, Salt Lake City, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jerry B. Black, Dds, Pc |
|---|---|
| Address | 1925 E 5600 S, Salt Lake City, Utah |
| Phone Number | 8012780458 |
| Fax Number | 8012780460 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Black Beck Jerry |
| Credentials | D.D.S. |
| Telephone Number | 8012780458 |
NPI Number Detail
| NPI Number | 1487696704 |
|---|---|
| Provider Enumeration Date | 2006-06-12 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1925 E 5600 S |
|---|---|
| City | Salt Lake City |
| State | Utah (UT) |
| Post Code | 841211351 |
| Phone Number | 8012780458 |
| Fax Number | 8012780460 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 137953 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4671 | UT | PEHP |
Post Comment/ Review Below
What is the unique identifier code issued to Jerry B. Black, Dds, Pc by the Centers for Medicare & Medicaid Services?
The Jerry B. Black, Dds, Pc has been assigned the NPI (National Provider Identifier) 1487696704. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Jerry B. Black, Dds, Pc?
The Jerry B. Black, Dds, Pc is physically situated at 1925 E 5600 S, in the city of Salt Lake City, state of UT, with the postal code 841211351.
What is Jerry B. Black, Dds, Pc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jerry B. Black, Dds, Pc is General Practice, and the taxonomy classification code that categorizes this area of expertise is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services issue the 1487696704 to Jerry B. Black, Dds, Pc?
The Jerry B. Black, Dds, Pc received its 1487696704 assignment from the Centers for Medicare & Medicaid Services on 2006-06-12.
As of what date was the information regarding Jerry B. Black, Dds, Pc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jerry B. Black, Dds, Pc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-08-22.