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General NPI Number Information
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NPI Number | 1780473900
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Entity Type | Individual
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Provider Name | DANA VARRIELLO
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Gender | Female
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 9809 39TH AVE STE 1
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City | PLEASANT PRAIRIE
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State | WI
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Zip | 53158-3733
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Country | US
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Telephone | 262-654-5623
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 S HIGHLAND AVE APT 577
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City | LOMBARD
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State | IL
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Zip | 60148-7152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6001851
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License Number State | WI
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