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DR. THERESA C FAN D.D.S.
NPI 1306921820
Dentist - General Practice in Manhasset, NY

Active since October 25, 2006PECOS EnrolledAccepts Medicare Assignment
400 COMMUNITY DR, MANHASSET, NY 11030(516) 562-4525 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Theresa C Fan D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THERESA C FAN D.D.S. (NPI 1306921820) is an individual general practice provider in Manhasset, New York, licensed in New York (0519371) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Columbia University College Of Dental Medicine (2004).

NPPES Registry Identity

NPI1306921820
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. THERESA C FANCredential: D.D.S.
Location Address400 COMMUNITY DRManhasset, NY 11030-3815
Mailing Address10 Sicardi CtCarle Place, NY 11514-1704 · (516) 997-7461
Phone(516) 562-4525
Sole ProprietorNo
Medical School CMSColumbia University College Of Dental MedicineGraduated 2004
Enumeration DateOctober 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1306921820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NY · 0519371
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
400 COMMUNITY DR, Manhasset, NY 11030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Theresa C Fan D.d.s. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618258534
PECOS Enrollment IDI20200810000209
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11030 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN ELLIOT GUIDO
Student in an Organized Health Care Education/Training Program
400 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-1300
RADICA PALMER
Nurse Practitioner (Adult Health)
400 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-2082
VALERIE LEVRANT
Student in an Organized Health Care Education/Training Program
400 COMMUNITY DR, NORTHWELL HEALTH, NSLIJ, DEPT. OF DENTAL MEDICINE
MANHASSET, NY 11030
Nassau County (718) 470-4120
IDA DANCYGER MD
Psychologist (Psychoanalysis)
400 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-3260
DR. JAMES SUNGSIK PARK MD
Internal Medicine (Transplant Hepatology)
400 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 472-5805
MADELEINE JEAN QUINN RDN
Dietitian, Registered
400 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-4276
DR. TANIA M. WINBERRY D.D.S.
Dentist (General Practice)
400 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-1300
PAUL J MATTIS PHD
Clinical Neuropsychologist
400 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-3054

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Fan's NPI number?

The NPI number for Theresa Fan is 1306921820. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Theresa Fan located?

Theresa Fan practices at 400 Community Dr, Manhasset, NY 11030. The listed phone number is (516) 562-4525.

What is Theresa Fan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Theresa Fan enrolled in Medicare?

Yes. Theresa Fan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theresa Fan accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana and 2 other insurers list Theresa Fan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Theresa Fan was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.