JINGYUAN FAN DDS
NPI 1952718629
Dentist - Periodontics in Downers Grove, IL

Q: What is Jingyuan Fan's NPI number?

The NPI number for Jingyuan Fan is 1952718629. It was assigned to this individual provider in the NPPES registry on July 15, 2014.

Q: What is Jingyuan Fan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: Is Jingyuan Fan enrolled in Medicare?

No. Jingyuan Fan has opted out of Medicare through July 1, 2028. 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.

Q: When was this NPI record last updated?

The NPPES record for Jingyuan Fan was last updated on August 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since July 15, 2014Opted out of Medicare · through Jul 1, 2028

3450 LACEY ROAD, DOWNERS GROVE, IL 60515(630) 743-4967(630) 743-4537 Get Directions Write a Review

NPPES record last updated: August 20, 2016. Verified against the NPPES registry weekly; last sync: September 13, 2026.

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About Jingyuan Fan Dds NPPES

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

JINGYUAN FAN DDS (NPI 1952718629) is an individual periodontics provider in Downers Grove, Illinois, licensed in New York (000054) and active in the NPI registry since July 2014. She has opted out of Medicare through July 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1952718629

Entity TypeIndividualFemale

Primary Taxonomy1223P0300X

Provider Legal NameJINGYUAN FANCredential: DDS

Location Address3450 LACEY ROADDowners Grove, IL 60515-2668

Mailing Address3450 Lacey RoadDowners Grove, IL 60515-2668 · (630) 743-4967 · Fax (630) 743-4537

Phone(630) 743-4967

Fax(630) 743-4537

Sole ProprietorNo

Enumeration DateJuly 15, 2014

Last NPPES UpdateAugust 20, 2016

✔ NPI 1952718629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in NY · 000054

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

3450 LACEY ROAD, Downers Grove, IL 60515

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, 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

ⓘ

Opted out of Medicare

Jingyuan Fan Dds 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 July 1, 2016 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2016

Opt-Out In Effect ThroughJuly 1, 2028Opt-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 60515 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

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

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 7

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

JILL BORCHERT PHARMD

Pharmacist (Pharmacotherapy)

3450 LACEY ROAD
DOWNERS GROVE, IL 60515

Dupage County (630) 515-7378

DR. KELLI CHRISTENSEN DDS

Dentist (General Practice)

3450 LACEY ROAD
DOWNERS GROVE, IL 60515

Dupage County (630) 743-4967

MS. PATRICIA J GIBBONS SLP

Speech-Language Pathologist

3450 LACEY ROAD
DOWNERS GROVE, IL 60515

Dupage County (630) 743-4967

DR. MELISA J BURTON

Dentist

3450 LACEY ROAD
DOWNERS GROVE, IL 60515

Dupage County (630) 743-4967

DR. TINA KATHALEEN VEALE PH.D., CCC-SLP

Speech-Language Pathologist

3450 LACEY ROAD, MIDWESTERN UNIVERSITY MULTISPECIALTY CLINIC
DOWNERS GROVE, IL 60515

Dupage County (630) 743-4500

REJI THOMAS MATHEW BDS, MDSC

Dentist (Oral and Maxillofacial Radiology)

3450 LACEY ROAD
DOWNERS GROVE, IL 60515

Dupage County (630) 743-4967

DR. ANGELINA SUSAN KULA DDS

Dentist (General Practice)

3450 LACEY ROAD
DOWNERS GROVE, IL 60515

Dupage County (630) 743-4967

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 Jingyuan Fan's NPI number?

The NPI number for Jingyuan Fan is 1952718629. It was assigned to this individual provider in the NPPES registry on July 15, 2014.

Where is Jingyuan Fan located?

Jingyuan Fan practices at 3450 Lacey Road, Downers Grove, IL 60515. The listed phone number is (630) 743-4967.

What is Jingyuan Fan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Jingyuan Fan enrolled in Medicare?

No. Jingyuan Fan has opted out of Medicare through July 1, 2028. 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.

What insurance does Jingyuan Fan accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 3 other insurers list Jingyuan 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 Jingyuan Fan was last updated on August 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.