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DR. SCOTT EDWARD DISTEFANO DDS
NPI 1861593014
Dentist - General Practice in Longview, TX

Active since September 26, 2006PECOS Enrolled
3535 N 4TH ST, STE 303, LONGVIEW, TX 75605(903) 759-4607(903) 759-3626 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Scott Edward Distefano Dds NPPES

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

DR. SCOTT EDWARD DISTEFANO DDS (NPI 1861593014) is an individual general practice provider in Longview, Texas, licensed in Texas (20261) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861593014
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. SCOTT EDWARD DISTEFANOCredential: DDS
Location Address3535 N 4TH ST, STE 303Longview, TX 75605
Mailing Address3535 N 4th St, Ste 303Longview, TX 75605 · (903) 759-4607 · Fax (903) 759-3626
Phone(903) 759-4607
Fax(903) 759-3626
Sole ProprietorYes
Enumeration DateSeptember 26, 2006
Last NPPES UpdateOctober 15, 2025
NPPES CertifiedOctober 15, 2025
✔ NPI 1861593014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 20261
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.
3535 N 4TH ST, Longview, TX 75605
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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. Scott Edward Distefano Dds 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 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 Scott Distefano's NPI number?

The NPI number for Scott Distefano is 1861593014. It was assigned to this individual provider in the NPPES registry on September 26, 2006.

Where is Scott Distefano located?

Scott Distefano practices at 3535 N 4th St Ste 303, Longview, TX 75605. The listed phone number is (903) 759-4607.

What is Scott Distefano's specialty?

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

Is Scott Distefano enrolled in Medicare?

Yes. Scott Distefano is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Scott Distefano was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.