Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eastside Periodontal Assoc PLLC

Organization Periodontics · NPI 1144312760

Eastside Periodontal Assoc PLLC is a Periodontics in Center Line, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

25523 Van Dyke Ave
Center Line, MI 48015-1824
Phone: (586) 757-5454
Fax: (586) 757-4147
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence B18275 (MI)

Record details

NPI number1144312760
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Wise — Office Manager · (586) 757-5454
NPI enumeratedSeptember 29, 2006
Last updated in NPPESAugust 22, 2020
Mailing address25523 Van Dyke Ave, Center Line, MI 48015-1824

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