Yijiao Fan, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

062596 Issued in NY

Practice address

14238 37TH Ave Ste 1G
Flushing, NY 11354-4580

Phone

(347) 943-1960

NPI assigned

May 11, 2016

Sex

Male

Sole proprietor

No

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Brighton Dental Practice LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
  • NPI 1306503792
  NPD (past)
• Flushing Oral Surgery - Dental Implants

  • Oral and Maxillofacial Surgery Clinic/Center
  • Flushing, NY
  • NPI 1326550302
  NPD (past)

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660348800000",
    "number": "1336595057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14238 37TH AVE STE 1G",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544580",
            "telephone_number": "347-943-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14238 37TH AVE STE 1G",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544580",
            "telephone_number": "347-943-1960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3019 Brighton 1st St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112358008",
            "country_code": "US",
            "telephone_number": "718-366-0070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "YIJIAO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2022-08-13",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "062596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Speech Language Pathology PC (Family Speech Center)
• Nancy I Fan-Paul, M.D.
• Chun-Yu Fan
• Wei Fan, DMD
• Wenxin Fan, MD
• Yizhi Fan, MHC-LP
• Bin Fang, A.A
• Ellen Fang, PHARM.D
• Emily Lin Fang
• Humphrey Fang, MD

• Oral and Maxillofacial Surgery (Dentist) in Flushing, NY
• Providers in Flushing, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.