OrganizationActive
East Lake Dental PLLC
NPI 1104401645 · General Practice Dentistry · South Lyon, MI
Provider details
- NPI number
- 1104401645
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- William Jenkins, Owner Dentist(248) 321-9485
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
201 S Lafayette St
South Lyon, MI 48178-1405
Phone: (248) 437-4119
Street-level locationGet directions
Mailing address
3542 Oakshire Ave
Berkley, MI 48072-3411
Registry dates
- Enumerated
- 2021-03-16
- Last updated
- 2021-03-16
- Certified
- 2021-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.