IndividualActive
John Fantasia, D.D.S.
NPI 1730258286 · Oral and Maxillofacial Pathology Dentistry · New Hyde Park, NY
Provider details
- NPI number
- 1730258286
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Pathology DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- 041799-1 (NY)
Practice location
27005 76th Ave
Lijmc
New Hyde Park, NY 11040-1433
Phone: (718) 470-7116
Fax: (718) 347-3483
Mailing address
27005 76th Ave
New Hyde Park, NY 11040-1433
Registry dates
- Enumerated
- 2006-11-07
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.