Individual provider Active NPI

Benjamin Eric Porras, D.M.D.

  • Endodontics
  • Myrtle Beach, SC
National Provider Identifier
1255684916
Registry record updated Sep 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
9688 Issued in SC
Practice address
4603 Oleander Dr Ste 6
Myrtle Beach, SC 29577-5738
Phone
(843) 492-7979
NPI assigned
Oct 18, 2012
Last updated
Sep 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19858 FL
Endodontics 1223E0200X 9688 SC Primary
Endodontics 1223E0200X DEN1001861 DC

Addresses

Primary practice location

4603 Oleander Dr Ste 6
Myrtle Beach, SC 29577-5738

Mailing address

584 Starlit Way
Myrtle Beach, SC 29579-4322

Other practice location 1

1376 Highway 17 N
North Myrtle Beach, SC 29582-2551
Phone (843) 353-3405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN19858FLMDDentist
DEN1001861DCMDEndodontist
9688SCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Big Waves Endodontics Endodontics CurrentSince Jun 16, 2024 Accepting new patients
Jebediah S Christy-North Myrtle Beach PLLC PastSince Nov 1, 2022 Accepting new patients

Locations

4603 Oleander Dr
Ste 6
Myrtle Beach, SC 29577
Phone (843) 492-7979

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758412800000",
    "number": "1255684916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 STARLIT WAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 OLEANDER DR STE 6",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775738",
            "telephone_number": "843-492-7979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1376 Highway 17 N",
            "address_purpose": "LOCATION",
            "city": "North Myrtle Beach",
            "state": "SC",
            "postal_code": "295822551",
            "country_code": "US",
            "telephone_number": "843-353-3405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORRAS",
        "first_name": "BENJAMIN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2025-09-21",
        "certification_date": "2025-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19858",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "9688",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "DC",
            "license": "DEN1001861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.