DR. MATTHEW KIMBALL BLACK


Address: 512 N Young St, Kennewick, WA 99336-7839
Phone: 5097837600

DR. MATTHEW KIMBALL BLACK (NPI# 1891173282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891173282
Entity Type Individual
Full Name DR. MATTHEW KIMBALL BLACK
Credential DDS
Practice Address 512 N Young St
Kennewick
WA 99336-7839
Practice Telephone 5097837600
Practice Fax Number 5097830774
Mailing Telephone 5097837600
Mailing Fax Number 5097830774
Enumeration Date 2015-05-18
Last Update Date 2020-08-28
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
61025296 WA Dental Providers
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
1201 N Stonewall Ave, Suite #206, Oklahoma City, OK 731171214 4052714441
476394 Us-95, Suite 201, Ponderay, ID 83852 2086640844 2086649682

Other Providers MATTHEW BLACK

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1639718745 Matthew David Black Hearing Instrument Specialist 3656 Washington Pkwy, Idaho Falls, ID 83404-7573 2020-01-06
1366922247 Matthew L Black Dietitian, Registered 410 W 10th Ave, W180 Doan Hall, Columbus, OH 43210 2018-08-20
1124512447 Matthew Black Optometrist 3901 Alpine Ave Nw, Comstock Park, MI 49321-8350 2018-06-20
1821509415 Matthew David Black Counselor 17606 Coshocton Rd, Mount Vernon, OH 43050-9218 2017-10-23
1518313824 Matthew Black Student in an Organized Health Care Education/Training Program 3500 Gaston Ave, Dallas, TX 75246-2017 2016-05-05
1275923955 Matthew Black Pharmacy Technician 45155 First Colony Way, Attn Pharmacy, California, MD 20619-2416 2015-02-02
1891010567 Matthew Crittenden Black Thoracic Surgery (Cardiothoracic Vascular Surgery) 200 Lothrop St., C800, Pittsburgh, PA 15213 2010-04-06
1437339900 Matthew Roger Black Emergency Medicine 12500 Willowbrook Rd, Cumberland, MD 21502-6393 2007-11-13
1679769947 Matthew John Black Physical Therapist 4004 S Yale Ave, Tulsa, OK 74135-6017 2007-09-20
1346395175 Matthew A. Black Counselor 601 Cumberland St, Chattanooga, TN 37404-1922 2007-01-24

Office Location

Street Address 512 N YOUNG ST
City KENNEWICK
State WA
Zip Code 99336-7839

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871523183 Todd C Cooper Dentist 512 N Young St, Kennewick, WA 99336-7806 2006-07-03
1134485154 Brandon William Reddinger Dentist 512 N Young St, Kennewick, WA 99336-7839 2012-04-03
1144596446 Proliance Surgeons, Inc., P.s. Orthopaedic Surgery 512 N Young St, Suite C, Kennewick, WA 99336-7806 2012-03-30
1609191576 Ryan Matthew Toponce Dentist 512 N Young St, Kennewick, WA 99336-7806 2010-04-02
1952505984 Tyson Teeples Dentist 512 N Young St, Kennewick, WA 99336-7806 2007-06-13
1316160237 Columbia Rheumatology Internal Medicine 512 N Young St, Suite C, Kennewick, WA 99336-7806 2007-04-10
1003935388 Tamara Shannan Simpson Orthopaedic Surgery 512 N Young St, Suite C, Kennewick, WA 99336-7806 2007-03-28
1487728614 Todd Cooper, Dds, Tyson Teeples, Dmd, Md, Ryan Toponce, Dmd, Ps. Dentist 512 N Young St, Kennewick, WA 99336-7806 2006-11-20
1750399275 Melvin M Wahl Jr. Orthopaedic Surgery 512 N Young St, Kennewick, WA 99336-7839 2006-08-03
1134147309 Ronald J Marsh Dentist 512 N Young St, Kennewick, WA 99336-7806 2006-07-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497393888 Kelsie D Parvinen Massage Therapist 8350 W. Grandridge Blvd, Suite 100, Kennewick, WA 99336 2019-12-16
1508403858 New U Women's Clinic & Aesthetics Pllc Nurse Practitioner 35 S Louisiana St, Suite A120, Kennewick, WA 99336 2019-12-05
1457901944 Solar Mobility LLC Durable Medical Equipment & Medical Supplies 949 S Keller St, Kennewick, WA 99336 2019-09-17
1023662590 Shane Arthur Gulley Counselor 500 N. Morain St Suite 1250, Kennewick, WA 99336 2019-08-01
1063973873 Farah Saleem Student in an Organized Health Care Education/Training Program 212 W. 10th Avenue,suite 202, Kennewick, WA 99336 2019-03-26
1255897690 Thomas Stanley Mcgowan Student in an Organized Health Care Education/Training Program Tri-cities Cancer Center, 7350 W. Deschutes Ave, Building A, Kennewick, WA 99336 2019-02-11
1770068280 Remedy Urgent Mobile Medicine Pllc Nurse Practitioner 3311 West Clearwater Avenue, Suite D210, Kennewick, WA 99336 2018-10-01
1740767011 Zachary Wilber Fournier Specialist/Technologist Toyota Center - 7000 West Grandridge Blvd, Kennewick, WA 99336 2018-07-19
1649780693 Alan Arnold Hanson Chiropractor 8350 W. Grandridge Blvd #100, Kennewick, WA 99336 2017-10-04
1922528827 Sarah Nicole Childress Counselor 415 North Morain St, Kennewick, WA 99336 2017-06-21
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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871523183 Todd C Cooper Dentist 512 N Young St, Kennewick, WA 99336-7806 2006-07-03
1609191576 Ryan Matthew Toponce Dentist 512 N Young St, Kennewick, WA 99336-7806 2010-04-02
1952505984 Tyson Teeples Dentist 512 N Young St, Kennewick, WA 99336-7806 2007-06-13
1487728614 Todd Cooper, Dds, Tyson Teeples, Dmd, Md, Ryan Toponce, Dmd, Ps. Dentist 512 N Young St, Kennewick, WA 99336-7806 2006-11-20
1134147309 Ronald J Marsh Dentist 512 N Young St, Kennewick, WA 99336-7806 2006-07-17
1720012503 Jonathan G Crawford Dentist 512 N Young St, Kennewick, WA 99336-7806 2006-07-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1023619657 Washington Jaw and Facial Surgery Pllc Dentist 451 Duvall Ave Ne Ste 100, Renton, WA 98059-4675 2020-11-02
1952909145 Calley Christie Dmd Pllc Dentist 275 Sw 160th St Ste 115, Burien, WA 98166-3003 2020-10-11
1679197016 Tae Youn Dds Md Pllc Dentist 15808 Mill Creek Blvd Ste 202, Mill Creek, WA 98012-1500 2020-06-02
1417416728 Sam Wise Dentist 1538 11th Ave Lowr Columbia, Longview, WA 98632 2019-03-16
1740744374 Thompson Ferguson Schrack Pllc Dentist 7604 Ne 5th Ave Ste 114, Vancouver, WA 98665-8200 2019-01-28
1053875096 John K Tidwell Dds and Elizabeth A Kutcipal Dds Pllc Dentist 1801 Nw Market St Ste 108, Seattle, WA 98107-3909 2019-01-23
1255803904 Edwards, Johnson, Johnson & Johnson D.d.s., P.l.l.c. Dentist 601 S Carr Rd Ste 300, Renton, WA 98055-5840 2018-12-19
1104396969 Mark Stivers, Dds, Inc., P.s. Dentist 12728 19th Ave Se Ste 101, Everett, WA 98208-6526 2018-12-04
1144797499 Washington Jaw and Facial Surgery Pllc Dentist 1370 116th Ave Ne Ste 101, Bellevue, WA 98004-3825 2018-10-25
1780151027 Washington Jaw and Facial Surgery Pllc Dentist 2111 N Northgate Way Ste 105, Seattle, WA 98133-9018 2018-10-25
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Competitor

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City KENNEWICK
Zip Code 99336

Improve Information

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Dataset Information

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.

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