Individual provider Active NPI

Esmaiel Tayara

  • General Practice Dentistry
  • Mentor, OH
National Provider Identifier
1144076340
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.028615 Issued in OH
Practice address
9140 Lake Shore Blvd
Mentor, OH 44060-1637
Phone
(440) 257-3900
NPI assigned
Apr 29, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.028615 OH Primary

Addresses

Primary practice location

9140 Lake Shore Blvd
Mentor, OH 44060-1637

Mailing address

9140 Lake Shore Blvd Ste 260
Mentor, OH 44060-1637
Phone (440) 257-3900

Other practice location 1

10512 S Highland Ave Apt 3A
Worth, IL 60482-1380
Phone (872) 802-8023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RES.004738OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mentor Dental Arts Ronald L. Micchia DDS, Inc. General Practice Past Accepting new patients
William E Mitman DDS and Assoc Inc General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1144076340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 LAKE SHORE BLVD STE 260",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601637",
            "telephone_number": "440-257-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9140 LAKE SHORE BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601637",
            "telephone_number": "440-257-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10512 S Highland Ave Apt 3A",
            "address_purpose": "LOCATION",
            "city": "Worth",
            "state": "IL",
            "postal_code": "604821380",
            "country_code": "US",
            "telephone_number": "872-802-8023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYARA",
        "first_name": "ESMAIEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-29",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.028615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.