Westside Pediatric Dentistry
NPI 1790808111ActiveOrganization· Dentist, Pediatric Dentistry· Rio Rancho, NM
Dentist, Pediatric Dentistry in Rio Rancho, New Mexico, registered in NPPES in April 2007. The authorized official on file is Raymond Eddie Broussard, DDS, Owner.
Overview
| NPI | 1790808111 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 9, 2007 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | DD1745 | 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 |
|---|
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