Zhiyong Fan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34007 Issued in TX

Practice address

1640 Highland Falls Dr Ste 901
Leander, TX 78641-4841

Phone

(512) 986-7196

Fax

(512) 986-7835

NPI assigned

Jun 11, 2018

Last updated

Jul 1, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Zhiyong Fan DDS PA

  • General Practice Dentistry
  • Leander, TX
  • NPI 1306502588
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1063905453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16238 RR 620 N STE F194",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787175212",
            "telephone_number": "713-380-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 HIGHLAND FALLS DR STE 901",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786414841",
            "telephone_number": "512-986-7196",
            "fax_number": "512-986-7835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3724 Jefferson St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787316219",
            "country_code": "US",
            "telephone_number": "512-452-4661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "ZHIYONG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fast Labs Mobile Lab Services LLC
• Faulkner Sports Medicine & Chiropractic (Apex Sports Medicine)

• General Practice Dentistry in Leander, TX
• Providers in Leander, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.