Paul R Black DDS PC
NPI 1487192407ActiveOrganization· Dentist, General Practice· Bettendorf, IA
Dentist, General Practice in Bettendorf, Iowa, registered in NPPES in February 2017. The authorized official on file is Paul Ralph Black, DDS, PC, Owner. Enrolled in Medicare as dme supplier - oral surgery - dentist.
Overview
| NPI | 1487192407 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 9, 2017 |
| Last updated in NPPES | Nov 26, 2025 |
| Certified by provider | Nov 26, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 7060 | IA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Oral Surgery - Dentist (IA) |
|---|
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