DR. ERIC BLACK (NPI# 1154364305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154364305 |
Entity Type | Individual |
Full Name | DR. ERIC BLACK |
Credential | DDS |
Practice Address |
2920 N 4th St Flagstaff AZ 86004-1816 |
Mailing Address |
Po Box 600 167 North Main Street Tuba City AZ 86045-0600 |
Practice Telephone | 9285229405 |
Practice Fax Number | 9285224808 |
Mailing Telephone | 9282832501 |
Mailing Fax Number | 9282832677 |
Enumeration Date | 2006-06-14 |
Last Update Date | 2014-09-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 122300000X | Dentist | DD2687 | NM | Dental Providers |
Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
6899 | AZ | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 974156 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174000285 | Eric Black | Pharmacist | 657 Us Highway 101 N, Crescent City, CA 95531-2306 | 2018-07-20 |
1730526013 | Eric J Black | Counselor | 1261 Chaffer Dr, Rochester Hills, MI 48306-3714 | 2013-05-28 |
1962874792 | Eric Black | Physician Assistant | 1650 Dixwell Ave, Hamden, CT 06514-3615 | 2015-10-20 |
1831528066 | Eric Black | Social Worker | 51 Market St, Bangor, PA 18013-1901 | 2013-11-07 |
1982863338 | Eric M Black | Orthopaedic Surgery | 140 Park Ave, Florham Park, NJ 07932-1049 | 2008-06-02 |
1245323005 | Eric Richard Black | Psychiatry & Neurology | 901 W Jefferson St, Springfield, IL 62702-4833 | 2006-10-02 |
1598877961 | Eric Lee Black | Pharmacist | 2339 Broadway St, Mount Vernon, IL 62864-2925 | 2006-08-31 |
Street Address |
2920 N 4TH ST |
City | FLAGSTAFF |
State | AZ |
Zip Code | 86004-1816 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831192913 | Karen Holder | Nurse Practitioner | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2005-05-23 |
1205433646 | Alma Araiza | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-10-08 |
1235742875 | Joseph Ijeomah Nnani | Pharmacist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-08-24 |
1881202976 | Tasha Harder | Student in an Organized Health Care Education/Training Program | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-07-15 |
1518585181 | Elizabeth Curtiss | Student in an Organized Health Care Education/Training Program | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-07-10 |
1669007043 | Raquel Ann Mickelson | Counselor | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-03-06 |
1326671595 | Dana Michelle Morrison | Dental Hygienist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2020-02-17 |
1396388740 | Lauren Marie Weinand | Family Medicine | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2019-10-17 |
1366098295 | Nicole Masako Paiva | Pharmacist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2019-08-15 |
1346896271 | Randi Braak | Pharmacist | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2019-08-15 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598387805 | Michael Joseph Oxtoby | Counselor | 2625 N. King St., Flagstaff, AZ 86004 | 2020-05-08 |
1083264501 | Dazhoni Elizabeth Scott | Counselor | 1500 E. Cedar Avenue #26, 2110 N. East St Apt C, Flagstaff, AZ 86004 | 2019-09-17 |
1760948046 | Emily Bauerle | Social Worker | 3009 N West St, Flagstaff, AZ 86004 | 2019-02-12 |
1992295745 | Kaibab Behavioral Services, Pllc | Behavioral Analyst | 2323 E Greenlaw Lane, Suite 12a, Flagstaff, AZ 86004 | 2018-05-17 |
1083115364 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 8800 Marys Drive, Flagstaff, AZ 86004 | 2018-02-22 |
1710391081 | Janet Coleman | Hearing Instrument Specialist | 1851 E Butler Avenue, Flagstaff, AZ 86004 | 2014-06-16 |
1568703163 | Mercy Timoh | Pharmacist | 4255 E. Soliere Ave., Flagstaff, AZ 86004 | 2013-03-06 |
1053617217 | Scott Nichols | Veterinarian | 6122 Abineau Canyon Drive, Flagstaff, AZ 86004 | 2011-02-07 |
1366745218 | Karoline S. Mariano | Registered Nurse | 3480 East Route 66, Flagstaff, AZ 86004 | 2010-12-15 |
1912209719 | Payal Parekh | Pharmacist | 1500 E Cedar, Flagstaff, AZ 86004 | 2010-11-30 |
Find all providers in zip 86004 |
Taxonomy Code | 1223D0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Dental Public Health |
The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407390826 | Westwinddental Unionhills | Dentist | 717 W Union Hills Dr, Phoenix, AZ 85027-5580 | 2016-12-05 |
1881007821 | Dallin Reed Snow | Dentist | 4540 E Baseline Rd Ste 110, Mesa, AZ 85206 | 2014-06-06 |
1104239508 | Irma Irene Paulley | Dentist | 10,000 S. Wilmot Rd, Tucson, AZ 85734 | 2014-06-04 |
1538580113 | Brian T. Hanstad | Dentist | 2105 N. Citrus Ln, Aspc-perryville, Phoenix, AZ 85395 | 2013-12-26 |
1538593157 | Arizona Department of Health Services | Dentist | 150 N 18th Avenue, Suite 320, Phoenix, AZ 85007-3205 | 2013-08-30 |
1609110915 | Sierra Sky Dental LLC | Dentist | 5259 W Indian School Rd, Suite 110, Phoenix, AZ 85031-2604 | 2012-11-27 |
1275800880 | Mark Edward Emshwiller | Dentist | 3212 N Winsong Drive, Prescott Valley, AZ 86314 | 2011-11-28 |
1497074231 | Ethan Foster Higson | Dentist | Highway 191 & Hospital Drive, Chinle, AZ 86503 | 2010-05-19 |
1154649101 | Meredith A Snyder | Dentist | Highway 191 and Hospital Drive, Chinle, AZ 86503 | 2010-05-13 |
1326166604 | Anthony Giacomo Brusca | Dentist | 1403 Birch St, Globe, AZ 85501-1328 | 2007-03-26 |
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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.