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DR. MARK JAMES BLACK DDS
NPI 1306286034
Dentist in Champaign, IL

Active since June 26, 2013
1717 BROADMOOR DR, CHAMPAIGN, IL 61821(217) 359-1541 Get Directions Write a Review

NPPES record last updated: June 26, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Mark James Black Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK JAMES BLACK DDS (NPI 1306286034) is an individual dentist in Champaign, Illinois, licensed in Illinois (019-023555) and active in the NPI registry since June 2013.

NPPES Registry Identity

NPI1306286034
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. MARK JAMES BLACKCredential: DDS
Location Address1717 BROADMOOR DRChampaign, IL 61821-5933
Mailing Address1717 Broadmoor DrChampaign, IL 61821-5933 · (217) 359-1541
Phone(217) 359-1541
Sole ProprietorNo
Enumeration DateJune 26, 2013
✔ NPI 1306286034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019-023555
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1717 BROADMOOR DR, Champaign, IL 61821
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRAY,YALLALY & BLACK, D.D.S., LTD.
Dentist (General Practice)
1717 BROADMOOR DR
CHAMPAIGN, IL 61821
Champaign County (217) 356-9344
DR. MARTHA MARGARET YALLALY D.M.D.
Dentist
1717 BROADMOOR DR
CHAMPAIGN, IL 61821
Champaign County (217) 359-5771
DANA GRAY DDS
Dentist
1717 BROADMOOR DR
CHAMPAIGN, IL 61821
Champaign County (217) 359-3112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Black's NPI number?

The NPI number for Mark Black is 1306286034. It was assigned to this individual provider in the NPPES registry on June 26, 2013.

Where is Mark Black located?

Mark Black practices at 1717 Broadmoor Dr, Champaign, IL 61821. The listed phone number is (217) 359-1541.

What is Mark Black's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Mark Black was last updated on June 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.