Healthcare Provider Details

I. General information

NPI: 1639096647
Provider Name (Legal Business Name): LENS SOCIETY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 15 MILE RD
STERLING HEIGHTS MI
48312-4213
US

IV. Provider business mailing address

30800 NORTHWESTERN HWY
FARMINGTON HILLS MI
48334-2569
US

V. Phone/Fax

Practice location:
  • Phone: 313-603-9517
  • Fax:
Mailing address:
  • Phone: 248-579-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN RENE SMITH
Title or Position: REGULATORY COMPLIANCE DIRECTOR
Credential: RN
Phone: 248-579-9700