BRIAN JERRY BLACK (NPI# 1457589483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457589483 |
| Entity Type | Individual |
| Full Name | BRIAN JERRY BLACK |
| Credential | D.D.S. |
| Practice Address |
1925 E 5600 S Salt Lake City UT 84121-1351 |
| Practice Telephone | 8012780458 |
| Practice Fax Number | 8012780460 |
| Mailing Telephone | 8012780458 |
| Mailing Fax Number | 8012780460 |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
7386388-9922 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891015996 | Brian Scott Black | Dentist | 219 Rock Prairie Rd, Ste. 100, College Station, TX 77845-8796 | 2010-06-11 |
| 1124146881 | Brian Harrison Black | Pharmacist | 216 Brushy Meadows Dr, Greer, SC 29650-1020 | 2007-03-27 |
| 1528590429 | Brian Black | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd Ste 308, Tampa, FL 33606-3438 | 2017-03-30 |
| 1679793426 | Brian Philip Black | Dentist | 11092 Anderson St, Loma Linda, CA 92354 | 2007-04-26 |
| 1437255239 | Brian Houston Black | Emergency Medicine | 1145 Indianapolis Rd, Greencastle, IN 46135-2408 | 2006-09-16 |
| 1649269473 | Brian Edward Black | Orthopaedic Surgery | 3033 W Layton Ave, Greenfield, WI 53221-2628 | 2005-10-14 |
| Street Address |
1925 E 5600 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121-1351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487696704 | Jerry B. Black, Dds, PC | Dentist | 1925 E 5600 S, Salt Lake City, UT 84121-1351 | 2006-06-12 |
| 1841547312 | Buxton Dentistry | Durable Medical Equipment & Medical Supplies | 1925 E 5600 S, Salt Lake City, UT 84121-1351 | 2012-08-14 |
| 1427094275 | O. Brent Black | Dentist | 1925 E 5600 S, Salt Lake City, UT 84121-1351 | 2006-06-21 |
| 1124062872 | Jerry Beck Black | Dentist | 1925 E 5600 S, Salt Lake City, UT 84121-1351 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| 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 |
|---|---|---|---|---|
| 1417575879 | Utah Family Dental Cottonwood Heights | Dentist | 7069 S Highland Dr Ste 200, Salt Lake City, UT 84121-3731 | 2020-07-10 |
| 1437772498 | Jordan Ames Whatcott | Dentist | 5888 S 900 E Ste 101, Salt Lake City, UT 84121-1644 | 2020-05-26 |
| 1043871783 | Morgan Park | Dentist | 223 S 700 E Ste 3, Salt Lake City, UT 84102-2174 | 2019-06-24 |
| 1730647330 | Salt Lake Modern Dentistry, LLP | Dentist | 1028 E 2100 S Ste 3, Salt Lake City, UT 84106-3096 | 2019-03-04 |
| 1336615244 | Jordan Heimer | Dentist | 1386 S Green St, Salt Lake City, UT 84105-2137 | 2018-10-18 |
| 1558852269 | Eric Gordon Russell | Dentist | 4465 S 900 E Ste 100, Salt Lake City, UT 84124-2695 | 2018-05-29 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1538687207 | Community Health Centers, Inc. | Dentist | 1078 S 300 E # 4, Salt Lake City, UT 84111-4638 | 2017-09-01 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1437682002 | Salt Lake Dental Care | Dentist | 279 E 5900 S Ste 202, Salt Lake City, UT 84107-5425 | 2017-04-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84121 |
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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.