Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306286034 Individual Practitioner Male Practitioner

Dr. Mark James Black , DDS

Dentist • Champaign, IL

Professional Overview & Biography Verified Profile Summary

Dr. Mark Black, DDS is a registered healthcare professional specializing in Dentist in Champaign, IL. Practice services are available at 1717 BROADMOOR DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1717 Broadmoor Dr

Champaign, IL 618215933

Telephone 2173591541
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Champaign, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
44 Specialists

Practicing in Champaign, IL (4751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IL 019-023555

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1770827495

Doctor of Dental Medicine

NPI 1891039590

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 26, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location June 26, 2013

Registered at 1717 BROADMOOR DR, CHAMPAIGN, IL 618215933 (Tel: 2173591541)

📍
Updated Business Mailing Address June 26, 2013

Registered at 1717 BROADMOOR DR, CHAMPAIGN, IL 618215933 (Tel: 2173591541)

👤
Provider Name / Credentials Updated June 26, 2013

Recorded as MARK BLACK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 26, 2013

Dentist (License #019-023555 in IL)

🟢
Initial NPI Registration & Enumeration June 26, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306286034
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 26, 2013
Last Update: June 26, 2013
Sole Proprietor: No

Mailing Address

1717 Broadmoor Dr

Champaign, IL 618215933

Phone: 2173591541

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.