Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. SAMANTHA JO SIMON D.D.S.
NPI 1881067700
Dentist in Maysville, KY

Q: What is Samantha Simon's NPI number?

The NPI number for Samantha Simon is 1881067700. It was assigned to this individual provider in the NPPES registry on November 2, 2015.

Q: What is Samantha Simon'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 Samantha Simon was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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 November 02, 2015PECOS Enrolled

927 KENTON STATION DR, MAYSVILLE, KY 41056(606) 796-9511 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 24, 2026, Mar 21, 2025 (2 updates tracked since 2025).

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About Dr. Samantha Jo Simon D.d.s. NPPES

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

DR. SAMANTHA JO SIMON D.D.S. (NPI 1881067700) is an individual dentist in Maysville, Kentucky, licensed in Missouri (2024040277) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1881067700

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. SAMANTHA JO SIMONCredential: D.D.S.

Location Address927 KENTON STATION DRMaysville, KY 41056-9617

Mailing Address2820 Lemay Ferry RdSaint Louis, MO 63125-3918 · (303) 604-2804

Phone(606) 796-9511

Sole ProprietorNo

Enumeration DateNovember 2, 2015

Last NPPES UpdateSeptember 24, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 24, 2026

✔ NPI 1881067700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in MO · 2024040277✔ Licensed in TN · 12632✔ Licensed in CO · DEN202695

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 ListedDentist · General PracticeTaxonomy 1223G0001X · License D-00298 (KY)

927 KENTON STATION DR, Maysville, KY 41056

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Secondary Practice Location 1

Location 12820 LeMay Ferry RdSaint Louis, MO 63125-3918 · Phone (303) 604-2804

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 (PECOS)

Dr. Samantha Jo Simon D.d.s. 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 41056 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH BLAIR LYKINS PHARMD

Pharmacist