JACK FAN DDS
NPI 1831455955
Dentist - General Practice in Austin, TX

Active since April 03, 2012
4301 W WILLIAM CANNON DR, BLDG B, SUITE 240, AUSTIN, TX 78749(512) 892-7800(512) 892-7805 Get Directions Write a Review

NPPES record last updated: November 9, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jack Fan Dds NPPES

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

JACK FAN DDS (NPI 1831455955) is an individual general practice provider in Austin, Texas, licensed in Texas (28806) and active in the NPI registry since April 2012.

NPPES Registry Identity

NPI1831455955
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJACK FANCredential: DDS
Location Address4301 W WILLIAM CANNON DR, BLDG B, SUITE 240Austin, TX 78749-1473
Mailing Address4301 W William Cannon Dr, Bldg B, Suite 240Austin, TX 78749-1473 · (512) 892-7800 · Fax (512) 892-7805
Fax(512) 892-7805
Sole ProprietorNo
Enumeration DateApril 3, 2012
Last NPPES UpdateNovember 9, 2016
NPI 1831455955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in TX · 28806
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.

4301 W WILLIAM CANNON DR, Austin, TX 78749

Other Identifiers 1

OtherTX 28806TX · Tx License

Accepted Insurance

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.

Optometrist
4301 W WILLIAM CANNON DR, STE B210
AUSTIN, TX 78749
Dietitian, Registered
4301 W WILLIAM CANNON DR, B210
AUSTIN, TX 78749
Eyewear Supplier
4301 W WILLIAM CANNON DR
AUSTIN, TX 78749
Optometrist
4301 W WILLIAM CANNON DR, SUITE B210
AUSTIN, TX 78749
Optometrist
4301 W WILLIAM CANNON DR, #B210
AUSTIN, TX 78749
Clinic/Center (Urgent Care)
4301 W WILLIAM CANNON DR, BUILDING E, SUITE 320
AUSTIN, TX 78749
Optometrist
4301 W WILLIAM CANNON DR, BUILDING A SUITE 100
AUSTIN, TX 78749
Behavior Analyst
4301 W WILLIAM CANNON DR, B-150
AUSTIN, TX 78749

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 1831455955. It was assigned to this individual provider in the NPPES registry on April 3, 2012.

Where is Jack Fan located?

Jack Fan practices at 4301 W William Cannon Dr Bldg B, Suite 240, Austin, TX 78749. The listed phone number is (512) 892-7800.

What is Jack Fan's specialty?

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

What insurance does Jack Fan accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 17 other insurers list Jack 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 Jack Fan was last updated on November 9, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.