Agave Dental Care North East, PLLC
NPI 1295499739ActiveOrganization· Dentist, General Practice· El Paso, TX
Dentist, General Practice in El Paso, Texas, registered in NPPES in October 2021. The authorized official on file is Jake Russell Williams, D.D.S., Owner/Dentist.
Overview
| NPI | 1295499739 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 29, 2021 |
| Last updated in NPPES | Oct 29, 2021 |
| Certified by provider | Oct 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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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