Jack George Soliman Botros, DDS, MS
NPI 1912721150ActiveIndividual· Dentist, Orofacial Pain· Minneapolis, MN
Dentist, Orofacial Pain (DDS, MS) in Minneapolis, Minnesota, licensed in KY and MN, with an NPI issued in November 2024. Enrolled in Medicare as practitioner - orofacial pain.
Overview
| NPI | 1912721150 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS, MS |
| Sole proprietor | Yes |
| NPI issued | Nov 13, 2024 |
| Last updated in NPPES | Sep 2, 2026 |
| Certified by provider | Sep 2, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Orofacial Pain Primary | 1223X2210X | D-00287 | KY |
| Dentist, Orofacial Pain | 1223X2210X | FF94 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Orofacial Pain (MN) |
|---|
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Orofacial Pain |
| Secondary specialties | Dentist |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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