Charles William Elwell Jr., DMD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Shalimar, FL
NPI 1932174356 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1932174356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- DN0012590 (FL)
- Practice address
- 7 Clifford Dr
Shalimar, FL 32579-1250 - Phone
- (850) 651-6882
- Fax
- (850) 651-6692
- NPI assigned
- Feb 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2013 through Jul 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN0012590 | FL | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oral and Maxillofacial Surgery Associates | Oral and Maxillofacial Surgery | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DN0012590 | FL | Yes |
Addresses
Primary practice location
7 Clifford Dr
Shalimar, FL 32579-1250
Mailing address
7 Clifford Dr
Shalimar, FL 32579-1250
Phone (850) 651-6882
Other providers in Shalimar, FL
- Dragonfly Behavioral Health Services LLC
- Dragonfly Counseling & Consulting, LLC
- April Drake
- Amy Driessen
- Nancy Dsilva
- Encompass Mental Health & Wellness
- Krista L Evans
- Calista Fairly
- Leonard Richard Folz Jr.
- Fort Walton Beach Heart & Lung Surgery
All providers in Shalimar, FL · Oral and Maxillofacial Surgery (Dentist) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.