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DR. BENJAMIN JON-SPOON SIMONTON DDS
NPI 1306074232
Dentist - Oral and Maxillofacial Surgery in Toledo, OH

Active since June 30, 2009Opted out of Medicare · through Aug 4, 2027
4646 NANTUCKETT STE A, TOLEDO, OH 43623(419) 517-2100(419) 517-2104 Get Directions Write a Review

NPPES record last updated: March 7, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Benjamin Jon-spoon Simonton Dds NPPES

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

DR. BENJAMIN JON-SPOON SIMONTON DDS (NPI 1306074232) is an individual oral and maxillofacial surgery provider in Toledo, Ohio, licensed in Michigan (2901020047) and active in the NPI registry since June 2009. He has opted out of Medicare through August 4, 2027 and remains eligible to order and refer, is affiliated with Wood County Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1306074232
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. BENJAMIN JON-SPOON SIMONTONCredential: DDS
Location Address4646 NANTUCKETT STE AToledo, OH 43623-3194
Mailing Address4646 Nantuckett Ste. AToledo, OH 43623-3194 · (419) 517-2100 · Fax (419) 517-2104
Phone(419) 517-2100
Fax(419) 517-2104
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateJune 30, 2009
Last NPPES UpdateMarch 7, 2017
✔ NPI 1306074232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MI · 2901020047
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
4646 NANTUCKETT STE A, Toledo, OH 43623
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

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. Benjamin Jon-spoon Simonton Dds 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 August 4, 2025 through August 4, 2027.

Opt-Out Effective DateAugust 4, 2025
Opt-Out In Effect ThroughAugust 4, 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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
16 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wood County Hospital

Acute Care Hospitals · Bowling Green, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360029
Location950 West Wooster StreetBowling Green, OH 43402 · Wood County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43623 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 Benjamin Simonton's NPI number?

The NPI number for Benjamin Simonton is 1306074232. It was assigned to this individual provider in the NPPES registry on June 30, 2009.

Where is Benjamin Simonton located?

Benjamin Simonton practices at 4646 Nantuckett Ste A, Toledo, OH 43623. The listed phone number is (419) 517-2100.

What is Benjamin Simonton's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Benjamin Simonton enrolled in Medicare?

No. Benjamin Simonton has opted out of Medicare through August 4, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Benjamin Simonton accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 10 other insurers list Benjamin Simonton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Benjamin Simonton affiliated with any hospitals?

According to CMS data, Benjamin Simonton is affiliated with Wood County Hospital.

When was this NPI record last updated?

The NPPES record for Benjamin Simonton was last updated on March 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.