Jacquese Olean Black is a Greensboro, North Carolina based Dentist who is specialized in
General Practice Dentistry. She does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Jacquese Olean Black is
6204 for General Practice Dentistry in North Carolina. Her current practice location is
900 Summit Ave, Greensboro. Patients can reach her at
336-370-1112.
Jacquese Olean Black is the primary dental care provider for patients of all ages. She is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Jacquese Olean Black speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Jacquese Olean Black |
| Specialization: | Dentist |
| Gender: | Female |
| Credentials: | DDS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 900 Summit Ave, Greensboro,
North Carolina, 27405-7918 |
| Phone: | 336-370-1112 |
| Fax: | 336-544-0739 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1649387382 |
| NPI Enumeration Date: | 25 Aug, 2006 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jacquese Olean Black are as mentioned below.
| License Number | Specialization | State | Status | |
| 6204 | General Practice Dentistry | North Carolina | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Jacquese Olean Black such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 90764 | Other | | BLUE CROSS BLUE SHIELD NC |
| 89-90764 | Medicaid | North Carolina | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2041 Silas Creek Pkwy,
Winston Salem, North Carolina |
| Zip: | 27103-5147 |
| Phone Number: | 336-777-0303 |
| Fax Number: | 336-777-3448 |
Patients can reach Jacquese Olean Black at
900 Summit Ave, Greensboro, North Carolina or can
call to book an appointment on 336-370-1112.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.