CHARLES BLACK III DMD PA (NPI# 1063568848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063568848 |
| Entity Type | Organization |
| Organization Name | CHARLES BLACK III DMD PA |
| Practice Address |
4728 Airport Blvd Suite C Mobile AL 36608 |
| Practice Telephone | 2513433415 |
| Practice Fax Number | 2513433417 |
| Mailing Telephone | 2513433415 |
| Mailing Fax Number | 2513433417 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHARLES BLACK III (OWNER) |
| Authorized Official Telephone | 2513433415 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
3146 | AL | Dental Providers |
| Street Address |
4728 AIRPORT BLVD SUITE C |
| City | MOBILE |
| State | AL |
| Zip Code | 36608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891809919 | Jon Bowie, D. M. D., P. C. | Clinic/Center | 4728 Airport Blvd, Suite A, Mobile, AL 36608-3170 | 2006-08-18 |
| 1811276371 | Bay Area Endodontics | Clinic/Center | 4728 Airport Blvd, Mobile, AL 36608-3170 | 2011-08-15 |
| 1972754950 | Charles Black IIi | Dentist | 4728 Airport Blvd, Suite C, Mobile, AL 36608 | 2008-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114088515 | Christopher D Mullenix | Dentist | 715 Downtowner Blvd, Mobile, AL 36609-5401 | 2006-12-12 |
| 1003894536 | C. Allen Martin Jr. | Dentist | 801 University Blvd S, Suite D, Mobile, AL 36609-2923 | 2006-01-05 |
| 1164400669 | Robert C Pfeffle | Dentist | 5901 Grelot Rd, Mobile, AL 36609-3603 | 2006-01-04 |
| 1396936589 | Ryan Stephen Sheppard | Dentist | 5901 Grelot Rd, Mobile, AL 36609-3603 | 2007-08-05 |
| 1730240870 | Joseph W Gunter | Dentist | 715 Downtowner Blvd, Mobile, AL 36609-5401 | 2006-12-13 |
| 1124189279 | Christopher Mullenix, Dmd, Md, PC | Dentist | 715 Downtowner Blvd, Mobile, AL 36609-5401 | 2006-12-13 |
| 1730104035 | David A Lairmore | Dentist | 6701 Airport Blvd, Suite D-238, Mobile, AL 36608-6705 | 2006-07-13 |
| 1699753111 | Gregory A Zieman | Dentist | 5901 Grelot Rd, Mobile, AL 36609-3603 | 2006-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336632561 | Gardendale Oral Surgery, P.C. | Dentist | 919 Sharit Ave Ste 201, Gardendale, AL 35071 | 2018-06-12 |
| 1275059941 | Birmingham Oms Oral Facial & Implant Surgery LLC | Dentist | 4244 Cahaba Heights Ct Ste 300, Vestavia, AL 35243-5711 | 2017-08-15 |
| 1407267321 | Walter Harris Wilson | Dentist | 2290 Valleydale Rd Ste 100, Hoover, AL 35244-2113 | 2014-05-13 |
| 1104168244 | David W Davis | Dentist | 901 Leighton Ave Ste 401, Anniston, AL 36207-5703 | 2013-03-26 |
| 1942575444 | Medwell Duncan Dental | Dentist | 2705 Pelham Pkwy, Pelham, AL 35124-1704 | 2012-03-15 |
| 1578855078 | David G Minto Jr. | Dentist | 19748 Greeno Rd, Fairhope, AL 36532-3836 | 2011-05-03 |
| 1134359664 | Florence Oral and Maxillofacial Surgery | Dentist | 154 Titan Drive, Florence, AL 35630 | 2009-07-17 |
| 1396991899 | Sam Enoch Pruett Jr. | Dentist | 2816 Bunny Ln Sw, Decatur, AL 35603-4250 | 2008-08-15 |
| 1124236047 | Thomas Hughes Fuqua Jr. | Dentist | 747 N Dean Rd, Auburn, AL 36830-4027 | 2007-05-21 |
| 1710196506 | Lisa Miller | Dentist | 1 Inverness Center Pkwy Ste 200, Birmingham, AL 35242-4865 | 2007-05-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.