DR. JACK ZHONGXU FAN DMD
NPI 1730070863
Dentist in Apo, AA

Q: What is Jack Fan's NPI number?

The NPI number for Jack Fan is 1730070863. It was assigned to this individual provider in the NPPES registry on July 15, 2025.

Q: What is Jack Fan's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jack Fan was last updated on August 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since July 15, 2025

FORT EISENHOWER DENTAC, BLDG 38717, APO, AA 30905(801) 647-5392 Get Directions Write a Review

NPPES record last updated: August 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jack Zhongxu Fan Dmd NPPES

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

DR. JACK ZHONGXU FAN DMD (NPI 1730070863) is an individual dentist in Apo, AA, licensed in Utah (14224225-9926) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1730070863

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. JACK ZHONGXU FANCredential: DMD

Location AddressFORT EISENHOWER DENTAC, BLDG 38717Apo, AA 30905

Mailing Address25501 Brainard AvenueFort Eisenhower, GA 30905

Phone(801) 647-5392

Sole ProprietorNo

Enumeration DateJuly 15, 2025

Last NPPES UpdateAugust 14, 2025

NPPES CertifiedAugust 12, 2025

✔ NPI 1730070863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in UT · 14224225-9926

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.

FORT EISENHOWER DENTAC, Apo, AA 30905

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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 Jack Fan's NPI number?

The NPI number for Jack Fan is 1730070863. It was assigned to this individual provider in the NPPES registry on July 15, 2025.

Where is Jack Fan located?

Jack Fan practices at Fort Eisenhower Dentac Bldg 38717, Apo, AA 30905. The listed phone number is (801) 647-5392.

What is Jack Fan's specialty?

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

When was this NPI record last updated?

The NPPES record for Jack Fan was last updated on August 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.