DR. JESSE MICHAEL FA (NPI# 1629291091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629291091 |
| Entity Type | Individual |
| Full Name | DR. JESSE MICHAEL FA |
| Credential | D.D.S |
| Practice Address |
2201 Balfour Rd Ste E Brentwood CA 94513-4927 |
| Mailing Address |
317 Windmill Canyon Pl Clayton CA 94517-1904 |
| Practice Telephone | 9253087908 |
| Practice Fax Number | 9253087910 |
| Mailing Telephone | 4155195620 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-04-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
55360 | CA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2390 Country Hills Dr Ste 103, Antioch, CA 945097437 | 9257572217 | 9257576417 |
| Street Address |
2201 BALFOUR RD STE E |
| City | BRENTWOOD |
| State | CA |
| Zip Code | 94513-4927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649689597 | Jesse M. Fa, Dds, Inc | Dentist | 2201 Balfour Rd Ste E, Brentwood, CA 94513-4927 | 2014-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154806008 | Brooke Bell | Student in an Organized Health Care Education/Training Program | 1780 Anastasia Drive, Brentwood, CA 94513 | 2018-09-26 |
| 1992287353 | Cheryl Lynn Dobson | Nurse Practitioner | 1206 Silverton Way, Brentwood, CA 94513 | 2018-09-02 |
| 1093212102 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 795 Eden Plains Road, Brentwood, CA 94513 | 2018-04-06 |
| 1851812838 | Vincent Robert Locascio | Dentist | 100 Cortona Way Ste 200, Brentwood, CA 94513 | 2017-06-29 |
| 1770012221 | Rosalind Sheila Raynor | Marriage & Family Therapist | Golden Hills Counseling Center, 2401 Shady Willow Ln., Brentwood, CA 94513 | 2017-06-08 |
| 1427592054 | Tekia Oliver | Private Vehicle | 2758 Saint Andrews Dr., Brentwood, CA 94513 | 2016-12-16 |
| 1467908681 | Abid Niazi | Student in an Organized Health Care Education/Training Program | 2108 Cristina Way, Brentwood, CA 94513 | 2016-08-28 |
| 1346600418 | Foundations Therapy Services | Specialist/Technologist | 101 Continente Ave, Suite 100, Brentwood, CA 94513 | 2016-03-02 |
| 1093171654 | Sabrina Samaniego | Behavioral Analyst | 809 Paririe Rose Way, Brentwood, CA 94513 | 2016-01-12 |
| 1477920841 | Susan C Novak-nizami | Registered Nurse | 2400 Balfour Rd., Patient Support Services, Brentwood, CA 94513 | 2015-09-01 |
| Find all providers in zip 94513 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831391515 | Dikran Deragopian | Dentist | 4411 Balfour Rd Ste B, Brentwood, CA 94513-1526 | 2007-06-04 |
| 1093932428 | Marek Adamiak | Dentist | 7106 Moores Ln, Brentwood, TN 37027-2903 | 2007-04-19 |
| 1932177698 | Anthony P Urbanek | Dentist | 8119 Isabella Ln Ste 108, Brentwood, TN 37027 | 2006-03-09 |
| 1891779278 | John L Guariglia | Dentist | 601 Suffolk Avenue, Ste 2, Brentwood, NY 11717 | 2005-11-30 |
| 1134123623 | Michael A. Arrow | Dentist | 2201 Balfour Rd, Ste E, Brentwood, CA 94513-4927 | 2005-06-13 |
| 1649689597 | Jesse M. Fa, Dds, Inc | Dentist | 2201 Balfour Rd Ste E, Brentwood, CA 94513-4927 | 2014-08-05 |
| 1104170547 | Oral Surgery Specialists of Brentwood | Dentist | 7004 Moores Ln, Brentwood, TN 37027-2905 | 2012-11-07 |
| 1891809695 | David Morgan Malin | Dentist | 343 Franklin Road, Suite 106, Brentwood, TN 37027-5250 | 2006-08-18 |
| 1831133362 | Christopher M First | Dentist | 601 Suffolk Ave, Suite 2, Brentwood, NY 11717-4309 | 2006-06-15 |
| 1093753758 | Suffolk Oral Surgery Associates LLP | Dentist | 601 Suffolk Ave, Suite 2, Brentwood, NY 11717-4309 | 2006-06-03 |
| Find all providers in BRENTWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.