DR. JACK FREDRICK BACKS D.M.D.
NPI 1104046556
Dentist - General Practice in Hermann, MO

Q: What is Jack Backs's NPI number?

The NPI number for Jack Backs is 1104046556. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Q: What is Jack Backs's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Jack Backs was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 26, 2007PECOS Enrolled

154 STATE ROUTE 100 W, HERMANN, MO 65041(573) 486-3500(573) 486-3166 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Dr. Jack Fredrick Backs D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK FREDRICK BACKS D.M.D. (NPI 1104046556) is an individual general practice provider in Hermann, Missouri, licensed in Missouri (DE 015082) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104046556

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. JACK FREDRICK BACKSCredential: D.M.D.

Location Address154 STATE ROUTE 100 WHermann, MO 65041-1526

Mailing Address154 State Route 100 WHermann, MO 65041-1526 · (573) 486-3500 · Fax (573) 486-3166

Phone(573) 486-3500

Fax(573) 486-3166

Sole ProprietorYes

Enumeration DateApril 26, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1104046556 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MO · DE 015082

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

154 STATE ROUTE 100 W, Hermann, MO 65041

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack Fredrick Backs D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65041 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Backs's NPI number?

The NPI number for Jack Backs is 1104046556. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Where is Jack Backs located?

Jack Backs practices at 154 State Route 100 W, Hermann, MO 65041. The listed phone number is (573) 486-3500.

What is Jack Backs's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Jack Backs enrolled in Medicare?

Yes. Jack Backs is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Backs was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.