DR. JACK GEORGE SOLIMAN BOTROS DDS MS NPI 1912721150

NPI Information

  • NPI: 1912721150
  • Provider Name: DR. JACK GEORGE SOLIMAN BOTROS, DDS, MS
  • Classification: Dentist - 1223X2210X
  • Specialization: Orofacial Pain
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 515 DELAWARE ST SE RM 6-440K
    MINNEAPOLIS, MN
    ZIP 55455
  • Phone: (213) 272-7573

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NPI Details

DR. Jack George Soliman Botros, DDS, MS is an orofacial pain dentist in Minneapolis, MN with 10 years of experience. The provider is a dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain. DR. Jack George Soliman Botros, DDS, MS NPI is 1912721150. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

515 DELAWARE ST SE RM 6-440K
MINNEAPOLIS, MN
ZIP 55455-357
Phone: (213) 272-7573

The NPI 1912721150 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/13/2024 and was last updated on 11/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223X2210XDentistOrofacial PainFF94MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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