Individual
DR. JUSTINE PAULA IPPOLITO-FATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
131-72 40TH ROAD, FLUSHING, NY 11354
(718) 587-1111
(718) 886-3903
Mailing address
125 WALKER ST FL 2, NEW YORK, NY 10013-4135
(212) 226-8866
(212) 226-2289
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043215
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02259254
—
NY
Enumeration date
10/25/2006
Last updated
07/02/2025
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