Justine Paula Ippolito-Fata, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

043215 Issued in NY

Practice address

131-72 40TH Road
Flushing, NY 11354

Phone

(718) 587-1111

Fax

(718) 886-3903

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Justine P Ippolito Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jippolito787530@direct.ochin.org
• Direct secure messaging: jippolitofata19243@sbhny.direct-ci.net
• Direct secure messaging: jippolitofata677033@nychhc.direct-ci.com
• Direct secure messaging: justine.ippolito-fata.1@18107.direct.athenahealth.com

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

• St. Barnabas Hospital

  • Dentist
  • Bronx, NY
  • NPI 1477228971
  Medicare reassignment NPD
• Hospital

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1730559477
  NPD (past) Authorized official
• St. Barnabas Hospital

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1326794173
  NPD
• Charles B. Wang Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1144203498
  NPD (past)
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  NPD (past)
• Lincon Medical and Mental Center

  • Critical Access Hospital
  • Bronx, NY
  • NPI 1902979651
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1902980691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WALKER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134135",
            "telephone_number": "212-226-8866",
            "fax_number": "212-226-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131-72 40TH ROAD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-587-1111",
            "fax_number": "718-886-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPPOLITO-FATA",
        "first_name": "JUSTINE",
        "middle_name": "PAULA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-07-02",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "043215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02259254",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "IPPOLITO",
            "middle_name": "P",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grace Interrante
• Daniela Iocco
• Silvestro Iommazzo Jr., D.D.S
• Matthew Iong, LMHC
• Ip101, LLC
• Shiza Iqbal
• Kashif Iqubal, MD
• John R Iraj, M.D.
• Irene Schulman Medical PC
• Iris & Optics Inc

• Dentist in Flushing, NY
• Providers in Flushing, NY by specialty
• Dentist in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.