MEDICARE: SMILEVERSE DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1629948625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILEVERSE DENTAL

Provider Business Mailing Address
First Line	:	3873 ROYAL VIEW ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-8066
Country	:	US
Telephone Number	:	432-559-0919
Fax Number	:

Provider Business Practice Location Address
First Line	:	4139 WHITE SAGE ARC
Second Line	:	SUITE A
City	:	LAS CRUCES
State	:	NM
Zip	:	88012
Country	:	US
Telephone Number	:	432-559-0919
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/ OWNER
Name	:	DR. FARQAD KAMAL ABUODUEH
Credential	:	DDS
Telephone Number	:	432-559-0919

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	01/12/2026

Similar Medicare Providers

1194699454 — TIMOTHY RAY JENKINS BS
Practice Location Address:

4844 CALLE BELLA AVE
LAS CRUCES, NM
88012-7066

Practice Phone: 575-382-5973
Practice Fax: 575-541-3635

1376401059 — TRACEY REYER
Practice Location Address:

3415 BATAAN MEMORIAL W
LAS CRUCES, NM
88012-5012

Practice Phone: 505-392-3482
Practice Fax:

1841159910 — ABIGAIL MOORE
Practice Location Address:

3415 BATAAN MEMORIAL W
LAS CRUCES, NM
88012-5012

Practice Phone: 505-392-3482
Practice Fax:

1336006295 — RICHARD SMITH
Practice Location Address:

6222 ROSEMARY RD
LAS CRUCES, NM
88012-0861

Practice Phone: 575-323-0456
Practice Fax:

1861359739 — BALANCE AND BLOOM BEHAVIORAL HEALTH LLC
Practice Location Address:

4656 VALENTINA RD
LAS CRUCES, NM
88012-0855

Practice Phone: 828-772-0128
Practice Fax:

1457344939 — HOWARD PRAY DDS
Practice Location Address:

1600 THORPE RD
LAS CRUCES, NM
88012-9776

Practice Phone: 505-267-3088
Practice Fax: 505-267-1747

Directions to “SMILEVERSE DENTAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.