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DR. JONATHAN PHAN D.M.D.
NPI 1316490956
Dentist in Austin, TX

Active since August 01, 2016
15004 AVERY RANCH BLVD BLDG SUITE100, AUSTIN, TX 78717(512) 246-7645 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jonathan Phan D.m.d. NPPES

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

DR. JONATHAN PHAN D.M.D. (NPI 1316490956) is an individual dentist in Austin, Texas, licensed in Texas (32869) and active in the NPI registry since August 2016. He maintains a secondary practice location in Cleveland.

NPPES Registry Identity

NPI1316490956
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JONATHAN PHANCredential: D.M.D.
Location Address15004 AVERY RANCH BLVD BLDG SUITE100Austin, TX 78717-4600
Mailing Address15004 Avery Ranch Blvd Ste 100Austin, TX 78717-4600 · (512) 246-7645
Phone(512) 246-7645
Sole ProprietorNo
Enumeration DateAugust 1, 2016
Last NPPES UpdateJanuary 20, 2021
NPPES CertifiedJanuary 20, 2021
✔ NPI 1316490956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in TX · 32869✔ Licensed in OH · 30-24859
Definition
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 degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
15004 AVERY RANCH BLVD BLDG SUITE100, Austin, TX 78717
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Secondary Practice Location 1

Location 12351 E 22nd St, ST. VINCENT CHARITY MEDICAL CENTERCleveland, OH 44115-3111 · Phone (216) 861-6200 · Fax (216) 363-7490

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 ›

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 Jonathan Phan's NPI number?

The NPI number for Jonathan Phan is 1316490956. It was assigned to this individual provider in the NPPES registry on August 1, 2016.

Where is Jonathan Phan located?

Jonathan Phan practices at 15004 Avery Ranch Blvd Bldg Suite100, Austin, TX 78717. The listed phone number is (512) 246-7645.

What is Jonathan Phan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Jonathan Phan 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 Delta Dental PPO and 3 other insurers list Jonathan Phan 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 Jonathan Phan was last updated on January 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.