Full Smile Dental Ark PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

FULL SMILE DENTAL ARK PLLC

Practice address

11965 Pellicano Dr
El Paso, TX 79936-6852

Phone

(915) 855-2337

NPI assigned

Jun 19, 2025

Organization subpart

No

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

Authorized official

Name

Dr. William Edward Graves, DMD

Title

Owner

Phone

(915) 855-2337

Specialties & licenses 2

Addresses

Tax ID family

Full Smile Dental Ark PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Full Smile Dental Ark PLLC

  • Dentist
  • El Paso, TX
  • NPI 1689504920
  NPD tax ID

Locations

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1508753864",
    "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": "806-381-3435",
            "fax_number": "806-353-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11965 PELLICANO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366852",
            "telephone_number": "915-855-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SMILE DENTAL ARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-855-2337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neomie Fuentes
• Yvonne Fuentes, LMSW
• Bradley Phillip Fuhrman, MD
• Akane Fukuda
• Full Life Psychology PLLC
• Full Smile Dental Ark PLLC
• Crystal Elizabeth Fuller, NP
• Erin Fuller
• Matthew Robert Fulton II, MD
• Natasha Furchtgott, DDS

• Pediatric Dentistry in El Paso, TX
• Providers in El Paso, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.