Full Smile Dental Colonies, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FULL SMILE DENTAL COLONIES, PLLC

Practice address

4515 Van Winkle Dr
Amarillo, TX 79119-6423

Phone

(806) 641-1373

Fax

(806) 353-7077

NPI assigned

May 25, 2021

Organization subpart

No

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

Authorized official

Name

William E Graves, DMD

Title

Owner

Phone

(806) 353-1055

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1538734249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 S SONCY RD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196667",
            "telephone_number": "806-353-1055",
            "fax_number": "806-353-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 VAN WINKLE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196423",
            "telephone_number": "806-641-1373",
            "fax_number": "806-353-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SMILE DENTAL COLONIES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-353-1055",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliazabeth A Friemel, LPC
• Craig Frost
• Vikki Jill Frost, PHARM.D.
• Eddie Fuentes
• Ashley Nora Fulcher, NP
• Full Smile Dental Georgia, PLLC (Full Smile Dental)
• Full Smile Dental, PLLC
• Full Smile Dental, PLLC (Full Smile Dental)
• Full Smile Endodontics, PLLC
• Full Smile Periodontics, PLLC

• General Practice Dentistry in Amarillo, TX
• Providers in Amarillo, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.