Lake Shore Dental Group PLLC
NPI 1093487555ActiveOrganization· Dentist, General Practice· Waco, TX
Dentist, General Practice in Waco, Texas, registered in NPPES in October 2021, part of Bright Dental Associates LLC. The authorized official on file is Traci Waldschmidt, Chief Operating Officer.
Overview
| NPI | 1093487555 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Bright Dental Associates LLC |
| NPI issued | Oct 4, 2021 |
| Last updated in NPPES | Oct 4, 2021 |
| Certified by provider | Oct 4, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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