FULL SMILE PERIODONTICS, PLLC
NPI 1083359368
Dentist - Periodontics in Amarillo, TX

Q: What is Full Smile Periodontics, PLLC's NPI number?

The NPI number for Full Smile Periodontics, PLLC is 1083359368. It was assigned to this organization in the NPPES registry on May 2, 2022.

Q: What is Full Smile Periodontics, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Active since May 02, 2022

4515 VAN WINKLE DR, AMARILLO, TX 79119(806) 699-6111(806) 353-7077 Get Directions Write a Review

NPPES record last updated: June 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Full Smile Periodontics, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FULL SMILE PERIODONTICS, PLLC (NPI 1083359368) is a healthcare organization registered as a periodontics in Amarillo, Texas and active in the NPI registry since May 2022. The organization maintains a secondary practice location in Amarillo and lists William E Graves, Owner, as its authorized official.

NPPES Registry Identity

NPI1083359368

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NameFULL SMILE PERIODONTICS, PLLC

Location Address4515 VAN WINKLE DRAmarillo, TX 79119-6423

Mailing Address5051 S Soncy RdAmarillo, TX 79119-6667 · (806) 353-1055 · Fax (806) 353-7077

Phone(806) 699-6111

Fax(806) 353-7077

Organization SubpartNo

Authorized OfficialWilliam E GravesOwner · (806) 353-1055

Enumeration DateMay 2, 2022

Last NPPES UpdateJune 3, 2022

NPPES CertifiedJune 3, 2022

✔ NPI 1083359368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

4515 VAN WINKLE DR, Amarillo, TX 79119

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Secondary Practice Location 1

Location 15051 S Soncy RdAmarillo, TX 79119-6667 · Phone (806) 353-1055 · Fax (806) 353-7077

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FONG CHU TSANG DMD

Dentist