NPIMap

Organization Active NPI

Jeanelle Marchese DMD, LTD

  • General Practice Dentistry
  • Lisle, IL
National Provider Identifier
1174991905
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019030388 Issued in IL
Legal business name
JEANELLE MARCHESE DMD, LTD
Practice address
1001 Ogden Ave
Suite C
Lisle, IL 60532-1395
Phone
(630) 220-8401
Fax
(630) 969-2341
NPI assigned
Sep 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Dr. Jeanelle Marchese, DMD
Title
Dentist
Phone
(630) 220-8401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019030388 IL Primary

Addresses

Primary practice location

1001 Ogden Ave
Suite C
Lisle, IL 60532-1395

Mailing address

1001 Ogden Ave
Suite C
Lisle, IL 60532-1395
Phone (630) 220-8401

National Provider Directory

National Provider Directory

Locations

1001 Ogden Ave
Ste C
Lisle, IL 60532
Phone (630) 220-8401

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1174991905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 OGDEN AVE",
            "address_2": "SUITE C",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321395",
            "telephone_number": "630-220-8401",
            "fax_number": "630-969-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 OGDEN AVE",
            "address_2": "SUITE C",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321395",
            "telephone_number": "630-220-8401",
            "fax_number": "630-969-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANELLE MARCHESE DMD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "MARCHESE",
        "authorized_official_first_name": "JEANELLE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "630-220-8401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.