Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1073434387 Individual Practitioner Male Practitioner

Jack Tan

Dentist • Vallejo, CA

Professional Overview & Biography Verified Profile Summary

Jack Tan is a registered healthcare professional specializing in Dentist in Vallejo, CA. Practice services are available at 201 WALNUT AVE BLDG 201 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

201 Walnut Ave Bldg 201

Vallejo, CA 945921107

Telephone 7075628200

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Vallejo, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
40 Specialists

Practicing in Vallejo, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-22
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 113095

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Maclyn Merritt , RDH

Dental Hygienist

NPI 1467064584

Registered Dental Hygienist

NPI 1720702053

Doctor of Dental Surgery

Cheri Schamun , RDH

Dental Hygienist

NPI 1881401818

Registered Dental Hygienist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 22, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location July 22, 2026

Registered at 201 WALNUT AVE BLDG 201, VALLEJO, CA 945921107 (Tel: 7075628200)

📍
Updated Business Mailing Address July 22, 2026

Registered at 377 EL PASEO, MILLBRAE, CA 940302313

👤
Provider Name / Credentials Updated July 22, 2026

Recorded as JACK TAN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2026

Dentist (License #113095 in CA)

🟢
Initial NPI Registration & Enumeration July 22, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073434387
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 22, 2026
Last Update: July 22, 2026
Sole Proprietor: No

Mailing Address

377 El Paseo

Millbrae, CA 940302313

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.