Jesse M. Fa, DDS, Inc
Jesse M. Fa, DDS, Inc is a healthcare organization registered as Oral and Maxillofacial Surgery (Dentist) in Antioch, CA, holding Type 2 (organization) NPI 1104349760 since 2017. The authorized official on file is Jesse Fa, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104349760 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Jesse M. Fa, DDS, Inc |
| Practice address | 2730 LONE TREE WAY STE 7, Antioch, CA, 94509 |
| Phone | 9257572217 |
| Fax | 9257576417 |
| Enumeration date | 2017-07-25 |
| Last updated in NPPES | 2018-03-17 |
Authorized official
| Name | Jesse Fa |
|---|---|
| Title | Owner |
| Phone | 9257572217 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | Primary | — | CA |
Copy-ready billing details
Provider: Jesse M. Fa, DDS, Inc NPI: 1104349760 Taxonomy: 1223S0112X (Oral and Maxillofacial Surgery (Dentist)) Address: 2730 LONE TREE WAY STE 7, Antioch, CA, 94509
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1336289354 | Noble Elcenko | Individual | Chiropractor | Antioch, CA |
Verify this record
Cross-check NPI 1104349760 against the authoritative CMS record: view Jesse M. Fa, DDS, Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Jesse M. Fa, DDS, Inc?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2018-03-17.