OrganizationActive
Eastside Periodontal Assoc PLLC
NPI 1144312760 · Periodontics · Center Line, MI
Eastside Periodontal Assoc PLLC is a Periodontics organization in Center Line, MI (NPI 1144312760).
Provider details
- NPI number
- 1144312760
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Jennifer Wise, Office Manager(586) 757-5454
- License
- B18275 (MI)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
25523 Van Dyke Ave
Center Line, MI 48015-1824
Phone: (586) 757-5454
Fax: (586) 757-4147
Street-level locationGet directions
Mailing address
25523 Van Dyke Ave
Center Line, MI 48015-1824
Registry dates
- Enumerated
- 2006-09-29
- Last updated
- 2020-08-22
Frequently asked questions
- What is Eastside Periodontal Assoc PLLC's NPI number?
- Eastside Periodontal Assoc PLLC's National Provider Identifier (NPI) is 1144312760, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Eastside Periodontal Assoc PLLC?
- Eastside Periodontal Assoc PLLC is classified in the NPPES registry as Periodontics (Dental Providers).
- Where is Eastside Periodontal Assoc PLLC located?
- Eastside Periodontal Assoc PLLC's practice location on file with NPPES is 25523 Van Dyke Ave, Center Line, MI 48015-1824.
- What is Eastside Periodontal Assoc PLLC's phone number?
- The practice phone number listed in the NPPES registry for Eastside Periodontal Assoc PLLC is (586) 757-5454.
- Who is the authorized official for Eastside Periodontal Assoc PLLC?
- The authorized official listed on Eastside Periodontal Assoc PLLC's NPPES record is Jennifer Wise, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Eastside Periodontal Assoc PLLC's NPI active?
- Yes — Eastside Periodontal Assoc PLLC's NPI (1144312760) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.