Cedar Lake Dental Professionals Ltd
NPI 1790840734ActiveOrganization· Dentist, General Practice· West Bend, WI
Dentist, General Practice in West Bend, Wisconsin, registered in NPPES in December 2006. The authorized official on file is Lysette L. Brueggeman, DDS, Owner.
Overview
| NPI | 1790840734 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 27, 2006 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 4368 | WI |
| Dentist, Prosthodontics | 1223P0700X | 4408 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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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