Individual provider · Type 1 NPI

Jerry Beck Black, DDS

Dentist · Salt Lake City, UT

NPI number 1124062872 Active

Practice location

1925 E 5600 S
Salt Lake City, UT 84121-1351

Call (801) 278-0458 Map

Fax (801) 278-0460

Mailing address

8913 Red Willow Cir
Sandy, UT 84093-1488

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	137953 (UT)

Dentist: 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 requiremen…

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About NPI 1124062872

Jerry Beck Black, DDS's National Provider Identifier is 1124062872, issued on Jun 15, 2006. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 13, 2026.