Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. JERRY F COX D.D.S
NPI 1154317493
Dentist - General Practice in Lebanon, MO

Active since September 22, 2005Opted out of Medicare · through Jun 1, 2027
803 S JEFFERSON AVE, LEBANON, MO 65536(417) 588-2555(417) 588-1359 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Jerry F Cox D.d.s NPPES

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

DR. JERRY F COX D.D.S (NPI 1154317493) is an individual general practice provider in Lebanon, Missouri, licensed in Missouri (12637) and active in the NPI registry since September 2005. He has opted out of Medicare through June 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1154317493
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JERRY F COXCredential: D.D.S
Location Address803 S JEFFERSON AVELebanon, MO 65536-3669
Mailing Address803 S Jefferson AveLebanon, MO 65536-3669
Fax(417) 588-1359
Sole ProprietorNo
Enumeration DateSeptember 22, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1154317493 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 · 12637
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.

803 S JEFFERSON AVE, Lebanon, MO 65536

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Jerry F Cox D.d.s has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 1, 2015 through June 1, 2027.

Opt-Out Effective DateJune 1, 2015
Opt-Out In Effect ThroughJune 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65536 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

The NPI number assigned to this healthcare provider is 1154317493, enumerated as an "individual" on September 22, 2005.

The provider is located at 803 S JEFFERSON AVE LEBANON, MO 65536 and the phone number is (417) 588-2555.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.