EASTSIDE DENTAL SPECIALISTS PLLC NPI 1740324052

NPI Information

  • NPI: 1740324052
  • Provider Name: EASTSIDE DENTAL SPECIALISTS PLLC
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Organization
  • Address: 24901 KELLY RD
    EASTPOINTE, MI
    ZIP 48021
  • Phone: (586) 772-2090

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NPI Details

EASTSIDE DENTAL SPECIALISTS PLLC is an endodontics dentist in Eastpointe, MI. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. EASTSIDE DENTAL SPECIALISTS PLLC NPI is 1740324052. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

24901 KELLY RD
EASTPOINTE, MI
ZIP 48021-367
Phone: (586) 772-2090
Fax: (586) 772-0742

The provider's authorized official is Robert Leonard Shore .
The authorized official title is President and has the following contact phone number (586) 772-2090.

The enumeration date for this NPI number is 2/19/2007 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistNo
21223G0001XDentistGeneral PracticeNo
31223P0221XDentistPediatric DentistryNo
41223P0300XDentistPeriodonticsNo
51223P0700XDentistProsthodonticsNo
61223S0112XDentistOral and Maxillofacial SurgeryNo
71223X0400XDentistOrthodontics and Dentofacial OrthopedicsNo
8124Q00000XDental HygienistNo
91223E0200XDentistEndodonticsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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