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DR. JAY EDWARD FANDEL D.M.D.
NPI 1417040940
Dentist in San Angelo, TX

Active since October 02, 2006Opted out of Medicare · through Oct 5, 2027
2102 PECOS ST STE 1, SAN ANGELO, TX 76901(325) 944-4984 Get Directions Write a Review

NPPES record last updated: September 22, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jay Edward Fandel D.m.d. NPPES

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

DR. JAY EDWARD FANDEL D.M.D. (NPI 1417040940) is an individual dentist in San Angelo, Texas, licensed in Mississippi (2612-91) and active in the NPI registry since October 2006. He has opted out of Medicare through October 5, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1417040940
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JAY EDWARD FANDELCredential: D.M.D.
Location Address2102 PECOS ST STE 1San Angelo, TX 76901-3061
Mailing Address5618 Woodbine LnSan Angelo, TX 76904 · (325) 654-3676
Phone(325) 944-4984
Sole ProprietorNo
Enumeration DateOctober 2, 2006
Last NPPES UpdateSeptember 22, 2022
NPPES CertifiedSeptember 22, 2022
✔ NPI 1417040940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MS · 2612-91
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.
2102 PECOS ST STE 1, San Angelo, TX 76901
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jay Edward Fandel D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 5, 2015 through October 5, 2027.

Opt-Out Effective DateOctober 5, 2015
Opt-Out In Effect ThroughOctober 5, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76901 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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

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

CONCHO VALLEY FAMILY DENTAL
Dentist (General Practice)
2102 PECOS ST STE 1
SAN ANGELO, TX 76901
Tom Green County (325) 944-4984

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 Jay Fandel's NPI number?

The NPI number for Jay Fandel is 1417040940. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Jay Fandel located?

Jay Fandel practices at 2102 Pecos St Ste 1, San Angelo, TX 76901. The listed phone number is (325) 944-4984.

What is Jay Fandel's specialty?

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

Is Jay Fandel enrolled in Medicare?

No. Jay Fandel has opted out of Medicare through October 5, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jay Fandel was last updated on September 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.