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Deactivated NPI 1508423591 Deactivated / Inactive NPI Male Practitioner

Dr. Jason Liddell Pan , DMD

Dentist - General Practice • Melrose, MA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jason Pan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 24, 2019
NPI Deactivation Date May 24, 2019
Total Practice Duration ~1 Years of Practice (2019 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Jason Pan, DMD was a registered Dentist - General Practice practicing in Melrose, MA. Throughout an active medical career spanning 1 years, Dr. Pan provided care at the practice location at 985 MAIN ST until profile deactivation on 2019-05-24.

Practice Location & Contact Primary Location

Practice Address

985 Main St

Melrose, MA 021761913

Telephone 7816655190
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Melrose, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
23 Specialists

Practicing in Melrose, MA (3722 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: 2020-08-26
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MA DN1858638

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Practice Locations

4100 W 3rd St

Dayton, OH 454289000

Phone: 2102937262

Practice Associates & Co-Workers

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

4 Associated Practitioners
Jeffrey Pan

Dentist - General Practice

NPI 1013369693
Dr. Katelyn Pan , DMD

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1447821400

Doctor of Dental Medicine

Dr. Nelson Pan , DDS

Dentist - General Practice

NPI 1598925703

Doctor of Dental Surgery

Dr. Debra Hong Pan , DMD

Dentist - General Practice

NPI 1659531481

Doctor of Dental Medicine

Career & Practice History Timeline

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

9 Historical Events
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Updated Practice Location August 26, 2020

Registered at 985 MAIN ST, MELROSE, MA 021761913 (Tel: 7816655190)

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 26, 2020

Dentist (License #DN1858638 in MA)

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NPI Profile Reactivated June 06, 2019

Record officially reactivated for active practice on June 06, 2019

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Updated Practice Location June 06, 2019

Registered at 4100 W 3RD ST, DAYTON, OH 454289000 (Tel: 2102937262)

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Updated Business Mailing Address June 06, 2019

Registered at 94 LARCHMONT RD, MELROSE, MA 021762503 (Tel: 6172725677)

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Provider Name / Credentials Updated June 06, 2019

Recorded as JASON PAN, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 06, 2019

Student in an Organized Health Care Education/Training Program

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NPI Profile Deactivated May 24, 2019

Record deactivated on May 24, 2019

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Initial NPI Registration & Enumeration May 24, 2019

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: 1508423591
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2019
Last Update: August 26, 2020
Deactivation Date: May 24, 2019
Sole Proprietor: No

Mailing Address

94 Larchmont Rd

Melrose, MA 021762503

Phone: 6172725677

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.