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JERRY B. BLACK, DDS, PC
NPI 1487696704
Dentist - General Practice in Salt Lake City, UT

Active since June 12, 2006
1925 E 5600 S, SALT LAKE CITY, UT 84121(801) 278-0458(801) 278-0460 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jerry B. Black, Dds, Pc NPPES

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

JERRY B. BLACK, DDS, PC (NPI 1487696704) is a healthcare organization registered as a general practice in Salt Lake City, Utah and active in the NPI registry since June 2006. The organization lists Jerry Beck Black, President, as its authorized official.

NPPES Registry Identity

NPI1487696704
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameJERRY B. BLACK, DDS, PC
Location Address1925 E 5600 SSalt Lake City, UT 84121-1351
Mailing Address8913 Red Willow CirSandy, UT 84093-1488 · (801) 255-6742 · Fax (801) 255-5170
Phone(801) 278-0458
Fax(801) 278-0460
Organization SubpartNo
Authorized OfficialJerry Beck BlackPresident · (801) 278-0458
Enumeration DateJune 12, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1487696704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in UT · 137953
Definition
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.
1925 E 5600 S, Salt Lake City, UT 84121
Open in Google Maps ↗

Other Identifiers 1

Other4671UT · Pehp

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

DR. JERRY BECK BLACK D.D.S.
Dentist
1925 E 5600 S
SALT LAKE CITY, UT 84121
Salt Lake County (801) 278-0458
BRIAN JERRY BLACK D.D.S.
Dentist (General Practice)
1925 E 5600 S
SALT LAKE CITY, UT 84121
Salt Lake County (801) 278-0458
DR. WILLIAM PERTTI SUNDBERG DDS
Dentist
1925 E 5600 S
HOLLADAY, UT 84121
Salt Lake County (801) 278-0458
BUXTON DENTISTRY
Durable Medical Equipment & Medical Supplies (Customized Equipment)
1925 E 5600 S
SALT LAKE CITY, UT 84121
Salt Lake County (801) 278-3214

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 Jerry B. Black, Dds, PC's NPI number?

The NPI number for Jerry B. Black, Dds, PC is 1487696704. It was assigned to this organization in the NPPES registry on June 12, 2006.

Where is Jerry B. Black, Dds, PC located?

Jerry B. Black, Dds, PC is located at 1925 E 5600 S, Salt Lake City, UT 84121. The listed phone number is (801) 278-0458.

What is Jerry B. Black, Dds, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Jerry B. Black, Dds, PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.