NPI age
14 years
Enumerated 2012-04-03
● Active
Type 1 · Individual
Jack Fan, DDS
Fan is 1 of 740 dentist providers in Austin and 1 of 15661 in Texas.
Primary specialty
Dentist
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2016-11-09
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 15661 active dentist providers in Texas.
NPI age
14 years
≈ at median (14 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
0
13% of peers hold subspecialties
NPI lifetime · 2012 → 2026
2012-04Enumerated in NPPES
2012
2026
Where they practice
Practice location
4301 W William Cannon Dr, Bldg B, Suite 240
Austin, TX 787491473
Mailing address
4301 W William Cannon Dr, Bldg B, Suite 240
Austin, TX 787491473
Specialties
-
Dentist PrimaryA 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | TX 28806 | TX LICENSE |
Practice context
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
Recently enumerated nearby: 9 new dentist providers have been added in Austin in the last 180 days.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.