Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. John Edward Fantasia, DDS

Individual provider Oral and Maxillofacial Pathology Dentistry · NPI 1730258286

Dr. John Edward Fantasia, DDS is an Oral Surgery in New Hyde Park, New York. Graduated from Emory University School of Medicine in 1975, 51 years ago. Practices with White Hall Dental, PC, a 10-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
51
Trained at
Emory University School of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

27005 76th Ave Lijmc
New Hyde Park, NY 11040-1433
Phone: (718) 470-7116
Fax: (718) 347-3483
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Pathology Dentistry (primary) Taxonomy 1223P0106X · Licence 041799-1 (NY)

Record details

NPI number1730258286
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedNovember 7, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Also practisesDENTIST, MAXILLOFACIAL SURGERY
Medical schoolEMORY UNIVERSITY SCHOOL OF MEDICINE
Graduated 1975 (51 years in practice)
Group practice White Hall Dental, Pc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in New Hyde Park