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Cedar Lake Dental Professionals Ltd

General Practice Dentistry in West Bend, WI · enumerated 2006 · authorized official Lysette Brueggeman, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1790840734

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Registry record

Entity type Organization (Type 2)
Legal business name Cedar Lake Dental Professionals Ltd
Practice address 145 N 18th Avenue, West Bend, WI, 53095
Phone (262) 334-3084
Fax (262) 334-3552
Enumeration date Dec 27, 2006
Last updated in NPPES Sep 11, 2025

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers · License 4368 (WI) Primary
1223P0700X Prosthodontics Dental Providers · License 4408 (WI) Secondary

Authorized official

Name Lysette Brueggeman
Title Owner
Phone (262) 334-3084

Other identifiers

Identifier Type State Issuer
33761800 Other WI MEDICAID
33713000 Medicaid WI -
650286 Other - UNITED CONCORDIA

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Cedar Lake Dental Professionals Ltd located?
The practice location on file with NPPES is in West Bend, WI.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-09-11. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-09-11.