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Active NPI 1639676166 Individual Practitioner Male Practitioner

Dr. Simon Lucas Mack , DDS

Dentist • Longview, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Simon Mack, DDS is a certified Dentist practicing in Longview, TX. With approximately 8 years of clinical experience since completing medical education in 2018, Dr. Mack delivers high-quality medical care to the local community at 3004 H.G. MOSLEY PKWY.

Dr. Mack is affiliated with East Texas Oral And Maxillofacial Surgery Associates Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3004 H.g. Mosley Pkwy

Longview, TX 75605

Telephone 9037583444
Fax 9037581967
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2018

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Longview, TX

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
8 Yrs -14.5 yrs vs City Avg
City Avg: 22.5 Yrs
State Avg: 18.7 Yrs
Regional Practice Density
26 Specialists

Practicing in Longview, TX (6851 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
20.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mack (8 Years) 8 Yrs
Longview Specialty Average (22.5 Years) 22.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99202 New patient office or other outpatient visit, typically 20 minutes
11 11 $86.55 $68.60

Medical Specialties & State Licenses

CMS Verified: 2022-09-09
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License TX 34781

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Hospital & Practice Group Affiliations

East Texas Oral And Maxillofacial Surgery Associates Inc

3004 H G Mosley Pkwy, Longview, TX 756052948

Phone: 9037583444

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1063594042

Doctor of Dental Surgery

NPI 1073606281

Doctor of Dental Surgery

Nathan Yang

Dentist - Oral and Maxillofacial Surgery

NPI 1679935076

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location September 09, 2022

Registered at 3004 H.G. MOSLEY PKWY, LONGVIEW, TX 75605 (Tel: 9037583444)

📍
Updated Business Mailing Address September 09, 2022

Registered at 3004 H.G. MOSLEY PKWY, LONGVIEW, TX 75605 (Tel: 9037583444)

👤
Provider Name / Credentials Updated September 09, 2022

Recorded as SIMON MACK, D.D.S.

NPI Profile Active April 11, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 11, 2018

Registered at 1501 KINGS HWY, SHREVEPORT, LA 711034228 (Tel: 3186260555)

📍
Updated Business Mailing Address April 11, 2018

Registered at 1501 KINGS HWY, SHREVEPORT, LA 711034228 (Tel: 3186260555)

👤
Provider Name / Credentials Updated April 11, 2018

Recorded as SIMON MACK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 11, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 11, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639676166
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 11, 2018
Last Update: September 09, 2022
Sole Proprietor: No

Mailing Address

3004 H.g. Mosley Pkwy

Longview, TX 75605

Phone: 9037583444

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.