Dr. Lynn Lo Fan, DDS
Dentist, General Practice in Fort Lee, NJ. Individual provider (NPI-1).
NPI number1962553057
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1962553057
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lynn Lo Fan
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 15, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DI01687700 | NJ | Yes |
Practice location
1625 Anderson AveSuite 302
Fort Lee, NJ 07024-2748
Phone 201-585-0847
Mailing address
1625 Anderson AveSuite 302
Fort Lee, NJ 07024-2748
Phone 201-585-0847
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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