Justin Riece Fazzolari
DMD, MD | Oral and Maxillofacial Surgeon
200 W 57th St Ste 804, New York
New York, 10019-3217
646-895-9680 Maps & DirectionsJustin Riece Fazzolari is a New York, New York based Oral and Maxillofacial Surgeon who is specialized in
Oral and Maxillofacial Surgery. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Justin Riece Fazzolari is
065003 for Oral and Maxillofacial Surgery in New York. His current practice location is
200 W 57th St Ste 804, New York. Patients can reach him at
646-895-9680.
Justin Riece Fazzolari deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Profile:
Justin Riece Fazzolari speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Justin Riece Fazzolari |
| Specialization: | Oral and Maxillofacial Surgeon |
| Gender: | Male |
| Credentials: | DMD, MD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 200 W 57th St Ste 804, New York,
New York, 10019-3217 |
| Phone: | 646-895-9680 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1295296168 |
| NPI Enumeration Date: | 25 Mar, 2019 |
| NPI Last Update On: | 19 Aug, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Justin Riece Fazzolari are as mentioned below.
| License Number | Specialization | State | Status | |
| 065003 | Oral and Maxillofacial Surgery | New York | Primary | |
| 22DI03028700 | Oral and Maxillofacial Surgery | New Jersey | Secondary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 200 W 57th St Ste 804,
New York, New York |
| Zip: | 10019-3217 |
| Phone Number: | 646-895-9680 |
Patients can reach Justin Riece Fazzolari at
200 W 57th St Ste 804, New York, New York or can
call to book an appointment on 646-895-9680.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.