OrganizationActive
Jerry B. Black, DDS, PC
NPI 1487696704 · General Practice Dentistry · Salt Lake City, UT
Provider details
- NPI number
- 1487696704
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jerry Black, President(801) 278-0458
- License
- 137953 (UT)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1925 E 5600 S
Salt Lake City, UT 84121-1351
Phone: (801) 278-0458
Fax: (801) 278-0460
Street-level locationGet directions
Mailing address
8913 Red Willow Cir
Sandy, UT 84093-1488
Registry dates
- Enumerated
- 2006-06-12
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.