DR. MISTY MICHELLE BLACK (NPI# 1194954180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194954180 |
| Entity Type | Individual |
| Full Name | DR. MISTY MICHELLE BLACK |
| Credential | D.D.S. |
| Practice Address |
1000 W Carson St Oral Surgery Box 19 Torrance CA 90502-2004 |
| Mailing Address |
1509 Hawthrone Blvd. Ste #102 Redondo Beach CA 90278 |
| Practice Telephone | 3106684675 |
| Mailing Telephone | 3103765252 |
| Mailing Fax Number | 3103765757 |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2017-01-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
59622 | CA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
390200000X | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STUDENT, HEALTH CARE | 390200000X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952628281 | Misty Dawn Black | Respiratory Therapist, Certified | 105 Chandler Way, Saint Marys, GA 31558-2935 | 2010-04-26 |
| 1043386220 | Misty Renae Black | Physical Therapist | 795 Farmers Ln, Ste 10, Santa Rosa, CA 95405-6718 | 2006-11-28 |
| Street Address |
1000 W CARSON ST ORAL SURGERY BOX 19 |
| City | TORRANCE |
| State | CA |
| Zip Code | 90502-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255324885 | Timothy L Vannatta | Surgery | 1000 W Carson St, Box 42, Torrance, CA 90502-2004 | 2005-08-30 |
| 1396354825 | Jonica Marie Rivas (gonzalez) | Registered Nurse | 1000 W Carson St, Torrance, CA 90502-2004 | 2020-07-30 |
| 1871102475 | Ronald Calderon | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2004 | 2020-07-29 |
| 1396353058 | Stephanie Munoz | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2004 | 2020-07-20 |
| 1720606247 | Fabiola Saucedo Macias | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2004 | 2020-07-10 |
| 1235755489 | Haya Nemtzov | Nurse Practitioner | 1000 W Carson St, Torrance, CA 90502-2059 | 2020-06-24 |
| 1588280945 | Ana Gabriela Vargas Garcia | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2004 | 2020-06-22 |
| 1699397984 | Edmond Ebubechukwu Onwukwe | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2004 | 2020-05-11 |
| 1902428238 | Jared Joshua Johnson | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2059 | 2020-05-08 |
| 1427679356 | Jonathan Rodney | Student in an Organized Health Care Education/Training Program | 1000 W Carson St, Torrance, CA 90502-2004 | 2020-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992319149 | Gia Chodzen | Student in an Organized Health Care Education/Training Program | Harbor-ucla Dmh, 1000 W Carson St, #488, Torrance, CA 90502 | 2020-09-04 |
| 1750994919 | Desiree Elise Cervantes | Social Worker | Harbor Ucla Medical Center, 1000 West Carson Street, Torrance, CA 90502 | 2020-08-27 |
| 1205448644 | Tabitha Tamara Black | Student in an Organized Health Care Education/Training Program | Harbor Ucla Dmh 1000 W Carson Street, Number 488, Torrance, CA 90502 | 2020-08-18 |
| 1538718531 | Harbor-ucla Dmh | Student in an Organized Health Care Education/Training Program | Harbor-ucla Dmh, 1000 W Carson St Box #498, Torrance, CA 90502 | 2019-09-11 |
| 1891345831 | Sydney Del Carmen Wheat | Student in an Organized Health Care Education/Training Program | 1000 W Carson St Box #488, Torrance, CA 90502 | 2019-09-11 |
| 1467971283 | Grace Y Kim | Student in an Organized Health Care Education/Training Program | Lacdmh Hucla 1000 W. Carson Street, Torrance, CA 90502 | 2017-09-13 |
| 1619498631 | Shauntel Locus | Case Manager/Care Coordinator | 1124 W. Carson Street, Torrance, CA 90502 | 2017-06-29 |
| 1740700079 | Charlise Brown-scranton | Registered Nurse | 711 W. Del Amo Blvd, Torrance, CA 90502 | 2017-06-27 |
| 1497280978 | C Edward Villasenor Castelo | Specialist | 1000 W Carson St # D5, Torrance, CA 90502 | 2017-04-21 |
| 1114464393 | Brissa Giron | Counselor | 19401 Vermont Ave, Suite C100, Torrance, CA 90502 | 2017-01-25 |
| Find all providers in zip 90502 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831717230 | Daniel Inouye | Dentist | 22850 Crenshaw Blvd Ste 102, Torrance, CA 90505-3055 | 2020-07-12 |
| 1174143747 | Dunlap Dentistry | Dentist | 3400 Lomita Blvd Ste 406, Torrance, CA 90505-4991 | 2020-04-23 |
| 1760953772 | O.h. Barkhordar Dental Group, Inc | Dentist | 23609 Hawthorne Blvd Ste B, Torrance, CA 90505-5903 | 2018-12-17 |
| 1790270486 | Juste Karvelyte | Dentist | 3500 Lomita Blvd Ste 201, Torrance, CA 90505 | 2018-06-26 |
| 1891288890 | Ehab Samaan Dds Inc | Dentist | 19019 Hawthorne Blvd Ste 100b, Torrance, CA 90503 | 2018-06-13 |
| 1164941068 | Angela Beatrice Fedonenko | Dentist | 2171 Torrance Blvd Ste 1, Torrance, CA 90501-2657 | 2017-09-12 |
| 1649796038 | Chan & Huang Dental Partnership | Dentist | 3640 Lomita Blvd., #208, Torrance, CA 90505 | 2017-08-17 |
| 1063949493 | Ahmad Zafar Karimi | Dentist | 4906 Halison St, Torrance, CA 90503-2048 | 2017-05-16 |
| 1306370796 | Steven Yun | Dentist | 2740 Arlington Ave Apt G, Torrance, CA 90501-7612 | 2017-04-12 |
| 1013467463 | Javid Dental Corporation | Dentist | 24667 Crenshaw Blvd, Suite D, Torrance, CA 90505-5360 | 2016-10-10 |
| Find all providers in TORRANCE | ||||
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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.