IndividualActive
Jack Botros, DDS, MS
NPI 1912721150 · Orofacial Pain Dentistry · Minneapolis, MN
Provider details
- NPI number
- 1912721150
- Entity type
- Individual
- Primary specialty
- Orofacial Pain DentistryDental Providers
- Credential
- DDS, MS
- Sex
- Male
- Sole proprietor
- Yes
- License
- FF94 (MN)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(55/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
515 Delaware St Se Rm 6-440k
Minneapolis, MN 55455-0357
Phone: (213) 272-7573
Street-level locationGet directions
Mailing address
515 Delaware St Se Rm 6-440k
Minneapolis, MN 55455-0357
Registry dates
- Enumerated
- 2024-11-13
- Last updated
- 2024-11-14
- Certified
- 2024-11-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.