Individual provider Active NPI

Vanessa J Kaplan, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Antioch, CA
National Provider Identifier
1164707899
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
58391 Issued in CA
Practice address
3600 Delta Fair Blvd
Antioch, CA 94509-4006
Phone
(925) 428-5820
NPI assigned
Oct 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 58391 CA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 10588 CO

Addresses

Primary practice location

3600 Delta Fair Blvd
Antioch, CA 94509-4006

Mailing address

16 The Nines
Lafayette, CA 94549-2044
Phone (805) 868-0404

Other practice location 1

3150 Balfour Rd Ste C
Brentwood, CA 94513-5520
Phone (925) 392-3157

Other identifiers 1

IdentifierTypeStateIssuer
45-3417167OtherCOFEIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
58391CAMDOrthodontics and Dentofacial Orthopedic Dentist
10588COMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacobson Dental Corp Orthodontics and Dentofacial Orthopedics CurrentSince Jul 9, 2025 Accepting new patients

Locations

3600 Delta Fair Blvd
Antioch, CA 94509
Phone (925) 428-5820

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1164707899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 THE NINES",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945492044",
            "telephone_number": "805-868-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 DELTA FAIR BLVD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094006",
            "telephone_number": "925-428-5820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3150 Balfour Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "CA",
            "postal_code": "945135520",
            "country_code": "US",
            "telephone_number": "925-392-3157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "VANESSA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "58391",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "10588",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "45-3417167",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.