OrganizationActive
East Lake Dental PLLC
NPI 1104401645 · General Practice Dentistry · South Lyon, MI
East Lake Dental PLLC is a General Practice Dentistry organization in South Lyon, MI (NPI 1104401645).
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(63/100 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
Frequently asked questions
- What is East Lake Dental PLLC's NPI number?
- East Lake Dental PLLC's National Provider Identifier (NPI) is 1104401645, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is East Lake Dental PLLC?
- East Lake Dental PLLC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is East Lake Dental PLLC located?
- East Lake Dental PLLC's practice location on file with NPPES is 201 S Lafayette St, South Lyon, MI 48178-1405.
- What is East Lake Dental PLLC's phone number?
- The practice phone number listed in the NPPES registry for East Lake Dental PLLC is (248) 437-4119.
- Who is the authorized official for East Lake Dental PLLC?
- The authorized official listed on East Lake Dental PLLC's NPPES record is William Jenkins, Owner Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is East Lake Dental PLLC's NPI active?
- Yes — East Lake Dental PLLC's NPI (1104401645) is active in the NPPES registry as of the last update on 2021-03-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.