Ellis Oaks Dental Center LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2406 Issued in SC

Legal business name

ELLIS OAKS DENTAL CENTER LLC

Practice address

776 Daniel Ellis Drive
Suite 3a
Charleston, SC 29412

Phone

(843) 762-2065

Fax

(843) 762-7735

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Teresa E Wilson

Title

Office Manager

Phone

(843) 762-2065

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Christy M Fogle DMD Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christy M Fogle, DMD

  • General Practice Dentistry
  • Charleston, SC
  • NPI 1265574529
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1023180528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BX 12290",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294222290",
            "telephone_number": "843-762-2065",
            "fax_number": "843-762-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 DANIEL ELLIS DRIVE",
            "address_2": "SUITE 3A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29412",
            "telephone_number": "843-762-2065",
            "fax_number": "843-762-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS OAKS DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-762-2065",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2406",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "2406",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9837",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z9A9837",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christy M Fogle DMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurie A Elliott, M.D.
• Marlie J Elliott
• Matthew Patrick Elliott, M.D.
• Stephen P Elliott, M.D.
• Thomas F Elliott
• Charles Robert Ellis, M.D.
• Christopher Ellis
• Sarah Green Ellis, ND
• Benjamin Asher Ellison, MD
• Britney Priscilla Ellison, RPH

• General Practice Dentistry in Charleston, SC
• Providers in Charleston, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.