ELLIS OAKS DENTAL CENTER LLC (NPI# 1023180528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023180528 |
| Entity Type | Organization |
| Organization Name | ELLIS OAKS DENTAL CENTER LLC |
| Other Organization Name | CHRISTY M FOGLE DMD |
| Practice Address |
776 Daniel Ellis Drive Suite 3a Charleston SC 29412 |
| Mailing Address |
Po Bx 12290 Charleston SC 29422-2290 |
| Practice Telephone | 8437622065 |
| Practice Fax Number | 8437627735 |
| Mailing Telephone | 8437622065 |
| Mailing Fax Number | 8437627735 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. TERESA E WILSON (OFFICE MANAGER) |
| Authorized Official Telephone | 8437622065 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QD0000X |
Clinic/Center Specialization: Dental |
2406 | SC | Ambulatory Health Care Facilities |
| X | 1223G0001X |
Dentist Specialization: General Practice |
2406 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | Z9A9837 | 05 | |
| SC | ZA9837 | 05 |
| Other Name | Type Code |
|---|---|
| Christy M Fogle DMD | Doing Business As Name - Organization |
| Street Address |
776 DANIEL ELLIS DRIVE SUITE 3A |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205365657 | Lowcountry Dental Arts, LLC | Dentist | 776 Daniel Ellis Drive, Suite 2b, Charleston, SC 29412 | 2017-06-08 |
| 1972804888 | Martine A Hutton | Pediatrics | 776 Daniel Ellis Drive, Suite 3c, Charleston, SC 29412 | 2010-11-09 |
| 1265574529 | Christy M Fogle | Dentist | 776 Daniel Ellis Drive, Suite 3a, Charleston, SC 29412 | 2007-02-13 |
| 1972676625 | Christy Chaleb Roberts | Physician Assistant | 776 Daniel Ellis Drive, Unit 1 A, Charleston, SC 29412-3034 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780219055 | Terra Rae Mchugh | Speech-Language Pathologist | 418 Folly Rd. Phc Rehab, Suite B, Charleston, SC 29412 | 2020-03-07 |
| 1437795747 | Brigitte Britt Huttemeyer | Nurse Practitioner | 678 Castle Pinckney Dr, Charleston, SC 29412 | 2019-11-21 |
| 1760956619 | Madison Culler, D.m.d., P.a. | Dentist | 211 Simmons Street, Mount Pleasant, SC 29412 | 2019-01-14 |
| 1366932717 | Harborview Speech Therapy, LLC | Speech-Language Pathologist | 783 Stebbins Street, Charleston, SC 29412 | 2018-05-11 |
| 1780193003 | Grace K Cotton | Speech-Language Pathologist | 1265 Marshview Dr, Charleston, SC 29412 | 2017-09-29 |
| 1639628449 | Matthew Husband | Occupational Therapist | 930 Folly Road, Suite B, Charleston, SC 29412 | 2016-09-22 |
| 1679941843 | Renee Poser | Pharmacist | 907 Folly Rd Suite A, James Island, SC 29412 | 2015-09-04 |
| 1508205717 | Amanda Marie Ashcraft | Dental Hygienist | 113 Wappoo Creek Drive Suite 5, James Island Dental Associates Pa, Charleston, SC 29412 | 2013-06-20 |
| 1104147818 | Glendolyn Harrison | Social Worker | 125e Wappoo Creek Drive, Suite 101e, Charleston, SC 29412 | 2010-06-16 |
| 1487986055 | Rachel E. Brunette | Physical Therapist | 418 B Folly Rd., Charleston, SC 29412 | 2010-02-08 |
| Find all providers in zip 29412 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497303770 | Holy City Dentistry LLC | Clinic/Center | 862 Folly Rd Ste 110, Charleston, SC 29412-3452 | 2019-08-29 |
| 1902345630 | Smile On Charleston, LLC | Clinic/Center | 91 Rutledge Ave, Charleston, SC 29401-1722 | 2017-02-14 |
| 1710389879 | Smileology Eco Dental Spa PC | Clinic/Center | 2106 Mount Pleasant St, # P-137, Charleston, SC 29403-3026 | 2014-09-19 |
| 1871848218 | Endodontic Associates of Charleston | Clinic/Center | 349 Folly Rd Ste 1c, Charleston, SC 29412-2508 | 2012-07-23 |
| 1295915866 | Charles E Wright Dds | Clinic/Center | 1005b Bridge Rd, Charleston, WV 25314-1305 | 2007-11-12 |
| 1740892827 | James Myers IIi LLC | Clinic/Center | 112 1/2 Ashley Ave, Charleston, SC 29401-1249 | 2020-08-19 |
| 1508478777 | Cfd Ji LLC | Clinic/Center | 693 Whispering Marsh Dr, Charleston, SC 29412-4423 | 2020-08-19 |
| 1932711314 | Charleston Family Dentistry of West Ashley | Clinic/Center | 2170 Savannah Hwy, Charleston, SC 29414-5311 | 2020-08-18 |
| 1104468172 | Charleston Dental & Dentures LLC | Clinic/Center | 2020 Savannah Hwy, Charleston, SC 29407-6286 | 2019-10-11 |
| 1740788330 | Joyner Family Dentistry LLC | Clinic/Center | 2030 Wambaw Crk Ste 106, Charleston, SC 29492-8382 | 2018-01-29 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29412 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.