Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Theresa C Fan, DDS

Individual provider General Practice Dentistry · NPI 1306921820

Dr. Theresa C Fan, DDS is a Dentist in Manhasset, New York. Graduated from Columbia University College of Dental Medicine in 2004, 22 years ago. Practices with Black Hall Dental PC, an 8-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
22
Trained at
Columbia University College of Dental Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

400 Community Dr
Manhasset, NY 11030-3815
Phone: (516) 562-4525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 0519371 (NY)

Record details

NPI number1306921820
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorNo
NPI enumeratedOctober 25, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDENTIST
Medical schoolCOLUMBIA UNIVERSITY COLLEGE OF DENTAL MEDICINE
Graduated 2004 (22 years in practice)
Group practice Black Hall Dental Pc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Manhasset