Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Simon Lucas Mack, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639676166

Dr. Simon Lucas Mack, DDS is a Dentist in Longview, Texas. Qualified in 2018, 8 years ago. Practices with East Texas Oral and Maxillofacial Surgery Associates Inc, a 3-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
8
Licensed in
TX
In the registry since
2018
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

3004 H.g Mosley Pkwy
Longview, TX 75605
Phone: (903) 758-3444
Fax: (903) 758-1967
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 34781 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639676166
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 11, 2018
Last updated in NPPESSeptember 9, 2022
Certification dateSeptember 9, 2022
Mailing address3004 H.G. Mosley Pkwy, Longview, TX 75605

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDENTIST
Also practisesORAL SURGERY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice East Texas Oral And Maxillofacial Surgery Associates Inc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Longview