Full Smile Eastern Family Dentistry, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FULL SMILE EASTERN FAMILY DENTISTRY, PLLC

Practice address

1521 W 18TH St
Portales, NM 88130-7018

Phone

(806) 353-1055

NPI assigned

Sep 10, 2024

Last updated

Dec 4, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lauren Ames Hodges

Title

Credentialing Specialist

Phone

(806) 353-1055

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1114753837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 CIVIC CIR STE 600",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091817",
            "telephone_number": "806-353-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 W 18TH ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881307018",
            "telephone_number": "806-353-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SMILE EASTERN FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "AMES",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "806-353-1055"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Floyd
• Lara Beebe Fordham
• Philip Ean Forrest
• Fos Wellness, LTD (Trinity Christian Care)
• Ciara Foust
• Brenda Lee Fuselier, CNP-APRN
• Lawrence Scott Gamble
• Alexandra Rene Garabedian
• April Bianca Garcia, LMSW
• Christian Jacob Garcia, LMSW

• General Practice Dentistry in Portales, NM
• Providers in Portales, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.