DR. SIMON LUCAS MACK D.D.S.
NPI 1639676166
Dentist in Longview, TX

Q: What is Simon Mack's NPI number?

The NPI number for Simon Mack is 1639676166. It was assigned to this individual provider in the NPPES registry on April 11, 2018.

Q: What is Simon Mack's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Simon Mack was last updated on September 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 11, 2018PECOS EnrolledAccepts Medicare Assignment

3004 H.G. MOSLEY PKWY, LONGVIEW, TX 75605(903) 758-3444(903) 758-1967 Get Directions Write a Review

NPPES record last updated: September 9, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 9, 2022, Apr 11, 2018 (2 updates tracked since 2018).

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About Dr. Simon Lucas Mack D.d.s. NPPES

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

DR. SIMON LUCAS MACK D.D.S. (NPI 1639676166) is an individual dentist in Longview, Texas, licensed in Texas (34781) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1639676166

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. SIMON LUCAS MACKCredential: D.D.S.

Location Address3004 H.G. MOSLEY PKWYLongview, TX 75605

Mailing Address3004 H.g. Mosley PkwyLongview, TX 75605 · (903) 758-3444 · Fax (903) 758-1967

Phone(903) 758-3444

Fax(903) 758-1967

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateApril 11, 2018

Last NPPES UpdateSeptember 9, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 9, 2022

✔ NPI 1639676166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in TX · 34781

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3004 H.G. MOSLEY PKWY, Longview, TX 75605

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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Simon Lucas Mack D.d.s. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082001524

PECOS Enrollment IDI20220502000042

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.

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.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75605 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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 Simon Mack's NPI number?

The NPI number for Simon Mack is 1639676166. It was assigned to this individual provider in the NPPES registry on April 11, 2018.

Where is Simon Mack located?

Simon Mack practices at 3004 H.G. Mosley Pkwy, Longview, TX 75605. The listed phone number is (903) 758-3444.

What is Simon Mack's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Simon Mack enrolled in Medicare?

Yes. Simon Mack is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Simon Mack accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 11 other insurers list Simon Mack 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.

When was this NPI record last updated?

The NPPES record for Simon Mack was last updated on September 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.