Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Adam Lysak, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629569553

Adam Lysak, DDS is a Student in an Organized Health Care Education/Training Program in Port Washington, Wisconsin. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

457 W Grand Ave
Port Washington, WI 53074-2143
Phone: (262) 284-9011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1629569553
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 26, 2018
Last updated in NPPESMay 26, 2018
Mailing address457 W Grand Ave, Port Washington, WI 53074-2143