Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mark James Black, DDS

Individual provider Dentist · NPI 1306286034

Dr. Mark James Black, DDS is a Dentist in Champaign, Illinois. Licensed in Illinois. Registered with an NPI since 2013.

Licensed in
IL
In the registry since
2013
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1717 Broadmoor Dr
Champaign, IL 61821-5933
Phone: (217) 359-1541
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019-023555 (IL)

Record details

NPI number1306286034
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJune 26, 2013
Last updated in NPPESJune 26, 2013
Mailing address1717 Broadmoor Dr, Champaign, IL 61821-5933

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