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DR. MATTHEW KIMBALL BLACK DDS
NPI 1891173282
Dentist - Oral and Maxillofacial Surgery in Kennewick, WA

Active since May 18, 2015Opted out of Medicare · through Jan 20, 2028
512 N YOUNG ST, KENNEWICK, WA 99336(509) 783-7600(509) 783-0774 Get Directions Write a Review

NPPES record last updated: August 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 28, 2020, Jul 3, 2019 (2 updates tracked since 2019).

About Dr. Matthew Kimball Black Dds NPPES

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

DR. MATTHEW KIMBALL BLACK DDS (NPI 1891173282) is an individual oral and maxillofacial surgery provider in Kennewick, Washington, licensed in Washington (61025296) and active in the NPI registry since May 2015. He has opted out of Medicare through January 20, 2028 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1891173282
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. MATTHEW KIMBALL BLACKCredential: DDS
Location Address512 N YOUNG STKennewick, WA 99336-7839
Mailing Address512 N Young StKennewick, WA 99336-7839 · (509) 783-7600 · Fax (509) 783-0774
Phone(509) 783-7600
Fax(509) 783-0774
Sole ProprietorNo
Enumeration DateMay 18, 2015
Last NPPES UpdateAugust 28, 20202 updates tracked since enumeration
NPPES CertifiedAugust 28, 2020
✔ NPI 1891173282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in WA · 61025296
Definition
An oral and maxillofacial surgery dentist specialized in 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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
512 N YOUNG ST, Kennewick, WA 99336
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11201 N Stonewall Ave, Suite #206Oklahoma City, OK 73117-1214 · Phone (405) 271-4441
Location 2476394 US-95, Suite 201Ponderay, ID 83852 · Phone (208) 664-0844 · Fax (208) 664-9682

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Matthew Kimball Black Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 20, 2020 through January 20, 2028.

Opt-Out Effective DateJanuary 20, 2020
Opt-Out In Effect ThroughJanuary 20, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99336 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

RONALD J MARSH DDS
Oral & Maxillofacial Surgery
512 N YOUNG ST
KENNEWICK, WA 99336
Benton County (509) 783-7600
DR. BRANDON WILLIAM REDDINGER D.D.S.
Dentist
512 N YOUNG ST
KENNEWICK, WA 99336
Benton County (509) 783-7600
PROLIANCE SURGEONS, INC., P.S.
Orthopaedic Surgery
512 N YOUNG ST, SUITE C
KENNEWICK, WA 99336
Benton County (509) 572-2605
COLUMBIA RHEUMATOLOGY
Internal Medicine (Rheumatology)
512 N YOUNG ST, SUITE C
KENNEWICK, WA 99336
Benton County (509) 783-2000
TODD COOPER, DDS, TYSON TEEPLES, DMD, MD, RYAN TOPONCE, DMD, PS.
Dentist (Oral and Maxillofacial Surgery)
512 N YOUNG ST
KENNEWICK, WA 99336
Benton County (509) 783-7600
RYAN MATTHEW TOPONCE
Dentist (Oral and Maxillofacial Surgery)
512 N YOUNG ST
KENNEWICK, WA 99336
Benton County (509) 783-7600
JONATHAN G CRAWFORD DDS
Oral & Maxillofacial Surgery
512 N YOUNG ST
KENNEWICK, WA 99336
Benton County (509) 783-7600
TODD C COOPER DDS
Oral & Maxillofacial Surgery
512 N YOUNG ST
KENNEWICK, WA 99336
Benton County (509) 783-7600

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 Matthew Black's NPI number?

The NPI number for Matthew Black is 1891173282. It was assigned to this individual provider in the NPPES registry on May 18, 2015.

Where is Matthew Black located?

Matthew Black practices at 512 N Young St, Kennewick, WA 99336. The listed phone number is (509) 783-7600.

What is Matthew Black's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Matthew Black enrolled in Medicare?

No. Matthew Black has opted out of Medicare through January 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Matthew Black accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and Renaissance Dental list Matthew Black as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Black was last updated on August 28, 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.