Fa5 Associates LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

FA5 ASSOCIATES LLC

Practice address

1 Crescent Dr Ste 300
Philadelphia, PA 19112-1015

Phone

(215) 389-3161

Fax

(215) 389-1036

NPI assigned

Jun 26, 2024

Organization subpart

No

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

Authorized official

Name

Joyce Lynn Ricks

Title

Credentialing

Phone

(610) 803-3745

Specialties & licenses 1

Addresses

Other names 1

• Navy Yard Dental Associates Doing business as

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1730924366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HERALD PL",
            "city": "ASTON",
            "state": "PA",
            "postal_code": "190142103",
            "telephone_number": "610-803-3745",
            "fax_number": "215-389-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CRESCENT DR STE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121015",
            "telephone_number": "215-389-3161",
            "fax_number": "215-389-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FA5 ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "610-803-3745"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Navy Yard Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chidozie Nnamdi Ezenekwe, PHARMD
• Chineme Lois Ezenekwe, RPH
• Paul L Ezeukwu, MSPT
• Celia Ezidiegwu, MD
• Daniel Raymond Ezzo, MD
• Elizabeth Fabens, MD
• Jillian Paige Faber
• Kenneth David Faber, PHARMD
• Matthew John Faber, PA-C
• Mark Fabi, M.D.

• Periodontics in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.