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LAKE SHORE DENTAL GROUP PLLC
NPI 1093487555
Dentist - General Practice in Waco, TX

Active since October 04, 2021
4535 LAKE SHORE DR, WACO, TX 76710(254) 776-7622(254) 776-7673 Get Directions Write a Review

NPPES record last updated: October 4, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lake Shore Dental Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SHORE DENTAL GROUP PLLC (NPI 1093487555) is a healthcare organization registered as a general practice in Waco, Texas and active in the NPI registry since October 2021. The organization lists Traci Waldschmidt, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1093487555
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameLAKE SHORE DENTAL GROUP PLLC
Location Address4535 LAKE SHORE DRWaco, TX 76710
Mailing Address4535 Lake Shore DrWaco, TX 76710-1814 · (254) 776-7622 · Fax (254) 776-7673
Phone(254) 776-7622
Fax(254) 776-7673
Organization SubpartYesParent: Bright Dental Associates Llc
Authorized OfficialTraci WaldschmidtChief Operating Officer · (254) 722-1083
Enumeration DateOctober 4, 2021
NPPES CertifiedOctober 4, 2021
✔ NPI 1093487555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
4535 LAKE SHORE DR, Waco, TX 76710
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Other Names 1

Other NameBright Dental Associates Llc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS WILSON WAGGENER D.D.S.
Dentist (General Practice)
4535 LAKE SHORE DR
WACO, TX 76710
McLennan County (254) 776-7622
LAKE SHORE DENTAL CARE, PLLC
Clinic/Center (Dental)
4535 LAKE SHORE DR
WACO, TX 76710
McLennan County (254) 414-0928

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Shore Dental Group PLLC's NPI number?

The NPI number for Lake Shore Dental Group PLLC is 1093487555. It was assigned to this organization in the NPPES registry on October 4, 2021. The provider is also known as Bright Dental Associates LLC.

Where is Lake Shore Dental Group PLLC located?

Lake Shore Dental Group PLLC is located at 4535 Lake Shore Dr, Waco, TX 76710. The listed phone number is (254) 776-7622.

What is Lake Shore Dental Group PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Lake Shore Dental Group PLLC was last updated on October 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.