Full Smile Eastern Family Dentistry, PLLC
NPI 1114753837ActiveOrganization· Dentist, General Practice· Portales, NM
Dentist, General Practice in Portales, New Mexico, registered in NPPES in September 2024. The authorized official on file is Lauren Ames Hodges, Credentialing Specialist.
Overview
| NPI | 1114753837 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 10, 2024 |
| Last updated in NPPES | Dec 4, 2025 |
| Certified by provider | Dec 4, 2025 |
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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