P Praxis·MD
● Active Type 1 · Individual

DR. Simon Lucas MacK, D.D.S.

Dentist·Longview, TX· NPI 1639676166 · Enumerated 2018 · 8 years on NPI
MacK is 1 of 22 dentist providers in Longview and 1 of 9237 in Texas.
NPI age
8 years
Enumerated 2018-04-11
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-09-09
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 9237 active dentist providers in Texas.

NPI age
8 years
↓ 4 yr below median (12 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
1
In the 16% of peers with subspecialties

NPI lifetime · 2018 → 2026

2018-04Enumerated in NPPES
2018 2026

Where they practice

Practice location
3004 H.g. Mosley Pkwy
Longview, TX 75605
📞 9037583444fax 9037581967
Mailing address
3004 H.g. Mosley Pkwy
Longview, TX 75605
📞 9037583444fax 9037581967

Specialties

  • Dentist Primary
    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...
    TX license #34781 taxonomy 122300000X
  • Student in an Organized Health Care Education/Training Program
    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.
    taxonomy 390200000X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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