CHANDA TRISHAUNE ELZIE MEDLOCK D.D.S.
NPI 1073531968
Dentist - General Practice in Okatie, SC

Q: What is Chanda Elzie Medlock's NPI number?

The NPI number for Chanda Elzie Medlock is 1073531968. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Q: What is Chanda Elzie Medlock's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since July 18, 2006PECOS Enrolled

719 OKATIE HWY # 170, OKATIE, SC 29909(843) 987-7400 Get Directions Write a Review

NPPES record last updated: March 11, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 11, 2020, Dec 14, 2016 (2 updates tracked since 2016).

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About Chanda Trishaune Elzie Medlock D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANDA TRISHAUNE ELZIE MEDLOCK D.D.S. (NPI 1073531968) is an individual general practice provider in Okatie, South Carolina, licensed in South Carolina (4669) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073531968

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameCHANDA TRISHAUNE ELZIE MEDLOCKCredential: D.D.S.

Location Address719 OKATIE HWY # 170Okatie, SC 29909-3963

Mailing AddressPo Box 357Ridgeland, SC 29936-2605 · (843) 987-7400

Phone(843) 987-7400

Sole ProprietorNo

Enumeration DateJuly 18, 2006

Last NPPES UpdateMarch 11, 20202 updates tracked since enumeration

NPPES CertifiedMarch 11, 2020

✔ NPI 1073531968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Licenses✔ Licensed in SC · 4669✔ Licensed in GA · 011979

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

719 OKATIE HWY # 170, Okatie, SC 29909

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chanda Trishaune Elzie Medlock D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Chanda Elzie Medlock reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beaufort Jasper Hampton Comprehensive Health Services, Inc.

Same address

Federally Qualified Health Center (FQHC)

719 N OKATIE HWY
Ridgeland, SC 29936

Reassigned Medicare billing, South Carolina enrollment
98 clinicians in this Medicare group

NPI 1649276148 (843) 987-7400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29909 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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