Embudo Dental Center LLC
NPI 1679017453ActiveOrganization· Clinic/Center, Dental· Embudo, NM
Clinic/Center, Dental in Embudo, New Mexico, registered in NPPES in December 2016. The authorized official on file is Kellie A. Harris, DDS, Owner/Dentist.
Overview
| NPI | 1679017453 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 13, 2016 |
| Last updated in NPPES | Dec 13, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center, Dental Primary | 261QD0000X | DD1953 | NM |
| Clinic/Center, Dental | 261QD0000X | DD1074 | NM |
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 |
|---|