Marylene Vitiello, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

021001441 Issued in IL

Practice address

1525 E 55TH St Ste 303
Chicago, IL 60615

Phone

(773) 947-9994

Fax

(773) 947-8281

NPI assigned

Jan 15, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tooth Fairy World PC

  • Pediatric Dentistry
  • Chicago, IL
  • NPI 1811055072
  NPD (past) Authorized official

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1538558408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 55TH ST STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155512",
            "telephone_number": "773-947-9994",
            "fax_number": "773-947-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 55TH ST STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60615",
            "telephone_number": "773-947-9994",
            "fax_number": "773-947-8281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2069 N Clybourn Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606144003",
            "country_code": "US",
            "telephone_number": "773-327-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VITIELLO",
        "first_name": "MARYLENE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "021001441",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021001441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vitas Healthcare Corporation of Illinois
• Dominic Vitello, MD
• Joseph M. Vitello, M.D.
• William A Vitello, MD
• Madhuri Mehta Vitha, PHARMD
• Marina Vitkin, DDS
• Vito P. Lasusa, D.D.S., LLC
• Colleen Vitt, LCSW
• Michael Zell Vitt, DPT
• Rachel Vittardi

• Pediatric Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.