James Tillman Black Jr, DDS in Los Angeles, CA

James Tillman Black Jr, DDS is a medicare enrolled "Dentist - General Practice" provider in Los Angeles, California. His current practice location is 3015 Crenshaw Blvd, Los Angeles, California. You can reach out to his office (for appointments etc.) via phone at (323) 731-0801.

James Tillman Black Jr is licensed to practice in California (license number 44148) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1801092648.

Contact Information

	James Tillman Black Jr, DDS
	3015 Crenshaw Blvd, Los Angeles, CA 90016-4264
	(323) 731-0801
	(323) 731-1351

Map and Direction

Healthcare Provider's Profile

Full Name	James Tillman Black Jr
Gender	Male
Speciality	Dentist - General Practice
Location	3015 Crenshaw Blvd, Los Angeles, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1801092648
Provider Enumeration Date: 06/26/2007
Last Update Date: 04/06/2017

Medicare PECOS Information:

PECOS PAC ID: 8820393515
Enrollment ID: I20170418001588

Medical Identifiers

Medical identifiers for James Tillman Black Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801092648	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	44148 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. James Tillman Black Jr allows following entities to bill medicare on his behalf.

Entity Name	James T Black Dds A Professional Dental Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871631622 PECOS PAC ID: 9032495098 Enrollment ID: O20170406000916

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. James Tillman Black Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
James Tillman Black Jr, DDS 3015 Crenshaw Blvd, Los Angeles, CA 90016-4264 Ph: (323) 731-0801	James Tillman Black Jr, DDS 3015 Crenshaw Blvd, Los Angeles, CA 90016-4264 Ph: (323) 731-0801

Reviews and Comments

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James Tillman Black Jr, DDS - Medicare Dentist in Los Angeles, CA