Provider Demographics
NPI:1235012196
Name:GIANNAMORE, MARLENA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARLENA
Middle Name:
Last Name:GIANNAMORE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 SEDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-7350
Mailing Address - Country:US
Mailing Address - Phone:203-232-0539
Mailing Address - Fax:
Practice Address - Street 1:720 N WASHINGTON ST STE 106
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3462
Practice Address - Country:US
Practice Address - Phone:630-420-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0363591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice