Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 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.

See every abbreviation used in this directory →

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Longview, TX

No coordinates on file. Search this address in Google Maps

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

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

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients20
Services billed 34 a service is one billed item, such as a visit, a test or a procedure
Average patient age76

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at East Texas Oral and Maxillofacial Surgery Associates Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice.

Other providers in Longview