Theresa C. Fan, D.D.S.
NPI 1306921820ActiveIndividual· Dentist, General Practice· Manhasset, NY
Dentist, General Practice (D.D.S.) in Manhasset, New York, trained at Columbia University College of Dental Medicine (class of 2004). Part D covered 21 prescriptions written in 2024, 100% of them generic.
Overview
| NPI | 1306921820 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.D.S. |
| Sole proprietor | No |
| NPI issued | Oct 25, 2006 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 0519371 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Dentist (NY) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 21 · 21 30-day fills |
|---|---|
| Patients | 16 |
| Total drug cost | $62.72 |
| Generic share | 100% of claims |
Education and affiliations
| Medical school | Columbia University College of Dental Medicine |
|---|---|
| Graduation year | 2004 |
| Medicare specialty | Dentist |
Medical group
- Black Hall Dental PCGlen Cove, NY · 8 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 23 general dentists in Manhasset · All general dentists in New York