Provider Demographics
NPI:1407733090
Name:VILENIO, AMANDA MARCELA (DDS)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARCELA
Last Name:VILENIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 BALLAD DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1101
Mailing Address - Country:US
Mailing Address - Phone:703-975-9605
Mailing Address - Fax:
Practice Address - Street 1:13019 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2621
Practice Address - Country:US
Practice Address - Phone:301-569-7269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice