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FULL SMILE EASTERN FAMILY DENTISTRY, PLLC
NPI 1114753837
Dentist - General Practice in Portales, NM

Active since September 10, 2024
1521 W 18TH ST, PORTALES, NM 88130(806) 353-1055 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 4, 2025, Sep 10, 2024 (2 updates tracked since 2024).

About Full Smile Eastern Family Dentistry, Pllc NPPES

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

FULL SMILE EASTERN FAMILY DENTISTRY, PLLC (NPI 1114753837) is a healthcare organization registered as a general practice in Portales, New Mexico and active in the NPI registry since September 2024. The organization lists Lauren Ames Hodges, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1114753837
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameFULL SMILE EASTERN FAMILY DENTISTRY, PLLC
Location Address1521 W 18TH STPortales, NM 88130-7018
Mailing Address2201 Civic Cir Ste 600Amarillo, TX 79109-1817 · (806) 353-1055
Phone(806) 353-1055
Organization SubpartNo
Authorized OfficialLauren Ames HodgesCredentialing Specialist · (806) 353-1055
Enumeration DateSeptember 10, 2024
Last NPPES UpdateDecember 4, 20252 updates tracked since enumeration
NPPES CertifiedDecember 4, 2025
✔ NPI 1114753837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1521 W 18TH ST, Portales, NM 88130
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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 4

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

DENTAL DESIGNS, PC
Dentist (General Practice)
1521 W 18TH ST
PORTALES, NM 88130
Roosevelt County (505) 369-5930
EASTERN FAMILY DENTISTRY, LLC
Dentist (General Practice)
1521 W 18TH ST
PORTALES, NM 88130
Roosevelt County (575) 356-8514
AARON MARK STANDING DMD
Dentist (General Practice)
1521 W 18TH ST
PORTALES, NM 88130
Roosevelt County (575) 356-8514
PORTALES DENTAL ARTS CENTER INC
Dentist
1521 W 18TH ST
PORTALES, NM 88130
Roosevelt County (505) 356-8514

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Full Smile Eastern Family Dentistry, PLLC's NPI number?

The NPI number for Full Smile Eastern Family Dentistry, PLLC is 1114753837. It was assigned to this organization in the NPPES registry on September 10, 2024.

Where is Full Smile Eastern Family Dentistry, PLLC located?

Full Smile Eastern Family Dentistry, PLLC is located at 1521 W 18th St, Portales, NM 88130. The listed phone number is (806) 353-1055.

What is Full Smile Eastern Family Dentistry, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Full Smile Eastern Family Dentistry, PLLC was last updated on December 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.