Healthcare Provider Details

I. General information

NPI: 1528800836
Provider Name (Legal Business Name): GIANNA TOMMARELLO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 W FRYE RD STE 4
CHANDLER AZ
85224-6280
US

IV. Provider business mailing address

1690 S SAN TAN VILLAGE PKWY APT 3122
GILBERT AZ
85295-0469
US

V. Phone/Fax

Practice location:
  • Phone: 480-917-8400
  • Fax:
Mailing address:
  • Phone: 412-580-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD012296
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD012296
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN29016
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: