DBA CRENSHAW PROFESSIONAL DENTAL CENTER
NPI 1871631622
Dentist - General Practice in Los Angeles, CA

Q: What is James T. Black, Dds A Professional Dental Corporation's specialty?

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

Active since February 02, 2007

3015 CRENSHAW BLVD, LOS ANGELES, CA 90016(323) 731-0801(323) 731-1351 Get Directions Write a Review

NPPES record last updated: April 11, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Dba Crenshaw Professional Dental Center NPPES

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

DBA CRENSHAW PROFESSIONAL DENTAL CENTER (NPI 1871631622) is a healthcare organization registered as a general practice in Los Angeles, California and active in the NPI registry since February 2007. The organization lists Jeanine T Black, Business Administrator, as its authorized official.

NPPES Registry Identity

NPI1871631622

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameJAMES T. BLACK, DDS A PROFESSIONAL DENTAL CORPORATION

Location Address3015 CRENSHAW BLVDLos Angeles, CA 90016-4264

Mailing Address3015 Crenshaw BlvdLos Angeles, CA 90016-4264 · (323) 731-0801 · Fax (323) 731-1351

Phone(323) 731-0801

Fax(323) 731-1351

Organization SubpartNo

Authorized OfficialJeanine T BlackBusiness Administrator · (323) 731-0801

Enumeration DateFebruary 2, 2007

Last NPPES UpdateApril 11, 2017

✔ NPI 1871631622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 17880

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.

3015 CRENSHAW BLVD, Los Angeles, CA 90016

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Other Names 1

Doing Business AsDba Crenshaw Professional Dental Center

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dba Crenshaw Professional Dental Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Dba Crenshaw Professional Dental Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

James Black, DDS

Oral Surgery

NPI 1801092648

3015 CRENSHAW BLVD
Los Angeles, CA 90016

(323) 731-0801

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 James T. Black, Dds A Professional Dental Corporation's NPI number?

The NPI number for James T. Black, Dds A Professional Dental Corporation is 1871631622. It was assigned to this organization in the NPPES registry on February 2, 2007. The provider is doing business as Dba Crenshaw Professional Dental Center.

Where is James T. Black, Dds A Professional Dental Corporation located?

James T. Black, Dds A Professional Dental Corporation is located at 3015 Crenshaw Blvd, Los Angeles, CA 90016. The listed phone number is (323) 731-0801.

What is James T. Black, Dds A Professional Dental Corporation's specialty?

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

Is James T. Black, Dds A Professional Dental Corporation enrolled in Medicare?

Yes. James T. Black, Dds A Professional Dental Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through James T. Black, Dds A Professional Dental Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to James T. Black, Dds A Professional Dental Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for James T. Black, Dds A Professional Dental Corporation was last updated on April 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.