Family Dental Health of Oakbrook

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILY DENTAL HEALTH OF OAKBROOK

Practice address

2680 Elms Plantation Blvd Ste 103
North Charleston, SC 29406-7101

Phone

(843) 797-6919

NPI assigned

Mar 27, 2023

Organization subpart

Yes

Parent organization

FDH HOLDINGSAs reported in NPPES

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

Authorized official

Name

Mrs. Beth Illsley

Title

Director of Insurance

Phone

(864) 282-1935

Specialties & licenses 1

Addresses

Other names 1

• Family Dental Health of Charleston Southern LLC 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.

• Peter D Mauldin, DMD

  • General Practice Dentistry
  • North Charleston, SC
  • NPI 1801689211
  NPD (past)

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1285338210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEMORIAL DRIVE EXT STE 400",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296511850",
            "telephone_number": "864-282-1935",
            "fax_number": "864-751-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 ELMS PLANTATION BLVD STE 103",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294067101",
            "telephone_number": "843-797-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL HEALTH OF OAKBROOK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FDH HOLDINGS",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "ILLSLEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "864-282-1935",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Health of Charleston Southern LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Ezsol
• Jenna Fabrizio, LCSW
• Caleb A Fackler, PHARMD, MBA
• Christopher Michael Fagerstrom, DC
• Matthew David Falter
• Family Laser Dental of North Charleston
• Family Laser Dental of North Charleston LLC
• Family Orthodontics of S. Carolina, LLC
• Family Services, Inc.
• Family Wellness Center of Charleston

• General Practice Dentistry in North Charleston, SC
• Providers in North 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 May 1, 2023; 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.