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DR. MARK ANTHONY CHISHOM DMD
NPI 1417908328
Oral & Maxillofacial Surgery in Elgin, SC

Active since May 15, 2006PECOS Enrolled
102 BUCKTHORN CIR, ELGIN, SC 29045(803) 477-4909 Get Directions Write a Review

NPPES record last updated: April 2, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mark Anthony Chishom Dmd NPPES

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

DR. MARK ANTHONY CHISHOM DMD (NPI 1417908328) is an individual oral & maxillofacial surgery provider in Elgin, South Carolina, licensed in South Carolina (3253) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417908328
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. MARK ANTHONY CHISHOMCredential: DMD
Location Address102 BUCKTHORN CIRElgin, SC 29045-8695
Mailing Address102 Buckthorn CirElgin, SC 29045-8695 · (803) 477-4909
Phone(803) 477-4909
Sole ProprietorNo
Enumeration DateMay 15, 2006
Last NPPES UpdateApril 2, 2015
✔ NPI 1417908328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in SC · 3253
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License DN014013 (GA)
102 BUCKTHORN CIR, Elgin, SC 29045
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Other Identifiers 2

Other117364United Concordia
MedicaidZX3253SC

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark Anthony Chishom Dmd 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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Chishom's NPI number?

The NPI number for Mark Chishom is 1417908328. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Where is Mark Chishom located?

Mark Chishom practices at 102 Buckthorn Cir, Elgin, SC 29045. The listed phone number is (803) 477-4909.

What is Mark Chishom's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Mark Chishom enrolled in Medicare?

Yes. Mark Chishom is registered in the Medicare PECOS enrollment system.

What insurance does Mark Chishom accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 12 other insurers list Mark Chishom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Chishom was last updated on April 2, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.