Healthcare Provider Details

I. General information

NPI: 1417829771
Provider Name (Legal Business Name): JSA DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 PLANTATION RD
DESTREHAN LA
70047-3016
US

IV. Provider business mailing address

242 GRUNER RD
METAIRIE LA
70001-5419
US

V. Phone/Fax

Practice location:
  • Phone: 318-243-4688
  • Fax:
Mailing address:
  • Phone: 318-243-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER JACOB ANTEE
Title or Position: OWNER
Credential: DDS
Phone: 318-243-4688