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

DR. JACK GEORGE SOLIMAN BOTROS DDS, MS
NPI 1912721150
Dentist - Orofacial Pain in Minneapolis, MN

Q: What is Jack Botros's NPI number?

The NPI number for Jack Botros is 1912721150. It was assigned to this individual provider in the NPPES registry on November 13, 2024.

Q: What is Jack Botros's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orofacial Pain, with taxonomy code 1223X2210X.

Q: When was this NPI record last updated?

The NPPES record for Jack Botros was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 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 13, 2024PECOS Enrolled

515 DELAWARE ST SE RM 6-440K, MINNEAPOLIS, MN 55455(213) 272-7573 Get Directions Write a Review

NPPES record last updated: July 30, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 30, 2026, Nov 14, 2024 (2 updates tracked since 2024).

On this page

About Dr. Jack George Soliman Botros Dds, Ms NPPES

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

DR. JACK GEORGE SOLIMAN BOTROS DDS, MS (NPI 1912721150) is an individual orofacial pain provider in Minneapolis, Minnesota, licensed in Minnesota (FF94) and active in the NPI registry since November 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1912721150

Entity TypeIndividualMale

Primary Taxonomy1223X2210X

Provider Legal NameDR. JACK GEORGE SOLIMAN BOTROSCredential: DDS, MS

Location Address515 DELAWARE ST SE RM 6-440KMinneapolis, MN 55455-0357

Mailing Address515 Delaware St Se Rm 6-440kMinneapolis, MN 55455-0357 · (612) 626-0140

Phone(213) 272-7573

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateNovember 13, 2024

Last NPPES UpdateJuly 30, 20262 updates tracked since enumeration

NPPES CertifiedJuly 30, 2026

✔ NPI 1912721150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Orofacial PainDental Providers

Taxonomy Code1223X2210X

License✔ Licensed in MN · FF94

Definition

A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.

515 DELAWARE ST SE RM 6-440K, Minneapolis, MN 55455

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.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. Jack George Soliman Botros Dds, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698202372

PECOS Enrollment IDI20241218004175

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 55455 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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 Jack Botros's NPI number?

The NPI number for Jack Botros is 1912721150. It was assigned to this individual provider in the NPPES registry on November 13, 2024.

Where is Jack Botros located?

Jack Botros practices at 515 Delaware St SE Rm 6-440k, Minneapolis, MN 55455. The listed phone number is (213) 272-7573.

What is Jack Botros's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orofacial Pain, with taxonomy code 1223X2210X.

Is Jack Botros enrolled in Medicare?

Yes. Jack Botros is registered in the Medicare PECOS enrollment system.

What insurance does Jack Botros accept?

Health plans from Medica list Jack Botros 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 Jack Botros was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 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.