NPIMap

Organization Active NPI

Painesville Dental Group

  • General Practice Dentistry
  • Painesville, OH
National Provider Identifier
1033296553
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PAINESVILLE DENTAL GROUP
Practice address
150 Mentor Ave
Painesville, OH 44077
Phone
(440) 354-2183
Fax
(440) 286-2476
NPI assigned
Nov 1, 2006
Organization subpart
Yes
Parent organization
PAINESVILLE DENTAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Jerry V Patriarca, DDSNPI 1144307661
Title
Officer/Member DDS
Phone
(440) 354-2183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

150 Mentor Ave
Painesville, OH 44077

Mailing address

150 Mentor Ave
Painesville, OH 44077
Phone (440) 354-2183

National Provider Directory

National Provider Directory
Part of
Painesville Dental Group

Locations

128 Mentor Ave
Painesville, OH 44077
Phone (440) 354-2183

150 Mentor Ave
Painesville, OH 44077
Phone (440) 354-2183

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1033296553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MENTOR AVE",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "44077",
            "telephone_number": "440-354-2183",
            "fax_number": "440-286-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MENTOR AVE",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "44077",
            "telephone_number": "440-354-2183",
            "fax_number": "440-286-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINESVILLE DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAINESVILLE DENTAL GROUP",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "PATRIARCA",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OFFICER/MEMBER  DDS",
        "authorized_official_telephone_number": "440-354-2183",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.