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JESSE M. FA, DDS, INC
NPI 1104349760
Dentist - Oral and Maxillofacial Surgery in Antioch, CA

Active since July 25, 2017
2730 LONE TREE WAY STE 7, ANTIOCH, CA 94509(925) 757-2217(925) 757-6417 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 17, 2018, Jul 25, 2017 (2 updates tracked since 2017).

About Jesse M. Fa, Dds, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSE M. FA, DDS, INC (NPI 1104349760) is a healthcare organization registered as an oral and maxillofacial surgery in Antioch, California and active in the NPI registry since July 2017. The organization maintains a secondary practice location in Brentwood and lists Jesse Michael Fa, Owner, as its authorized official.

NPPES Registry Identity

NPI1104349760
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameJESSE M. FA, DDS, INC
Location Address2730 LONE TREE WAY STE 7Antioch, CA 94509-4964
Mailing Address2730 Lone Tree Way Ste 7Antioch, CA 94509-4964 · (925) 757-2217 · Fax (925) 757-6417
Phone(925) 757-2217
Fax(925) 757-6417
Organization SubpartNo
Authorized OfficialJesse Michael FaOwner · (925) 757-2217
Enumeration DateJuly 25, 2017
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1104349760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2730 LONE TREE WAY STE 7, Antioch, CA 94509
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Secondary Practice Location 1

Location 12201 Balfour Rd Ste EBrentwood, CA 94513-4927 · Phone (925) 308-7908 · Fax (925) 308-7910

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOBLE OZORY ELCENKO DC
Chiropractor
2730 LONE TREE WAY STE 7
ANTIOCH, CA 94509
Contra Costa County (925) 685-8223

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jesse M. Fa, Dds, Inc's NPI number?

The NPI number for Jesse M. Fa, Dds, Inc is 1104349760. It was assigned to this organization in the NPPES registry on July 25, 2017.

Where is Jesse M. Fa, Dds, Inc located?

Jesse M. Fa, Dds, Inc is located at 2730 Lone Tree Way Ste 7, Antioch, CA 94509. The listed phone number is (925) 757-2217.

What is Jesse M. Fa, Dds, Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Jesse M. Fa, Dds, Inc was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.