OrganizationActive
Green Lakes Dental, LLP
NPI 1174259212 · Dental Clinic/Center · Fayetteville, NY
Green Lakes Dental, LLP is a Dental Clinic/Center organization in Fayetteville, NY (NPI 1174259212).
Provider details
- NPI number
- 1174259212
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tyler Maxwell, Owner(315) 637-4616
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 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
511 E Genesee St
Fayetteville, NY 13066-1524
Phone: (315) 637-4616
Street-level locationGet directions
Mailing address
511 E Genesee St
Fayetteville, NY 13066-1524
Registry dates
- Enumerated
- 2022-07-30
- Last updated
- 2022-07-30
- Certified
- 2022-07-30
Frequently asked questions
- What is Green Lakes Dental, LLP's NPI number?
- Green Lakes Dental, LLP's National Provider Identifier (NPI) is 1174259212, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Green Lakes Dental, LLP?
- Green Lakes Dental, LLP is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Green Lakes Dental, LLP located?
- Green Lakes Dental, LLP's practice location on file with NPPES is 511 E Genesee St, Fayetteville, NY 13066-1524.
- What is Green Lakes Dental, LLP's phone number?
- The practice phone number listed in the NPPES registry for Green Lakes Dental, LLP is (315) 637-4616.
- Who is the authorized official for Green Lakes Dental, LLP?
- The authorized official listed on Green Lakes Dental, LLP's NPPES record is Tyler Maxwell, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Green Lakes Dental, LLP's NPI active?
- Yes — Green Lakes Dental, LLP's NPI (1174259212) is active in the NPPES registry as of the last update on 2022-07-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.