South Lyon Dermatology, PC
NPI 1407233323 · Dermatology Physician · South Lyon, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
South Lyon Dermatology, PC is a Dermatology Physician organization in South Lyon, MI (NPI 1407233323).
Provider details
- NPI number
- 1407233323
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Angela Clay, Authorized Rep/Owner(248) 479-2200
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
Mailing address
Registry dates
- Enumerated
- 2015-04-29
- Last updated
- 2015-07-16
Frequently asked questions
- What is South Lyon Dermatology, PC's NPI number?
- South Lyon Dermatology, PC's National Provider Identifier (NPI) is 1407233323, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Lyon Dermatology, PC?
- South Lyon Dermatology, PC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is South Lyon Dermatology, PC located?
- South Lyon Dermatology, PC's practice location on file with NPPES is 26036 Pontiac Trl, South Lyon, MI 48178-8050.
- What is South Lyon Dermatology, PC's phone number?
- The practice phone number listed in the NPPES registry for South Lyon Dermatology, PC is (248) 479-2200.
- Does South Lyon Dermatology, PC accept Medicare?
- South Lyon Dermatology, PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for South Lyon Dermatology, PC?
- The authorized official listed on South Lyon Dermatology, PC's NPPES record is Angela Clay, Authorized Rep/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Lyon Dermatology, PC's NPI active?
- Yes — South Lyon Dermatology, PC's NPI (1407233323) is active in the NPPES registry as of the last update on 2015-07-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.