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).
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 |
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 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
Street Address |
512 N YOUNG ST |
City | KENNEWICK |
State | WA |
Zip Code | 99336-7839 |
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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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 |
Find all providers in zip 99336 |
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 |
---|---|---|---|---|
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 |
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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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.