Benjamin Theodore

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.11518.GD Issued in SC

Practice address

1247 Highway 17
Little River, SC 29566-9211

Phone

(843) 249-4092

NPI assigned

Jul 13, 2026

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Coastal Cosmetic Dental Associates,

  • General Practice Dentistry
  • Little River, SC
  • NPI 1437284270
  NPD (past)
• Dental Professionals of South Carolina, P.C.

  • General Practice Dentistry
  • Little River, SC
  • NPI 1558128058
  NPD (past)

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

{
    "created_epoch": "1783900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700705902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 HIGHWAY 17",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 HIGHWAY 17",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669211",
            "telephone_number": "843-249-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.11518.GD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Symposium Emergency Physicians, LLC
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• The Human Performance and Wellness Center
• The Human Performance and Wellness Center
• Thomas Drugs Inc
• Linda Susan Thomas
• Donna Rae Thompson, LMSW
• Treva Marie Timmons, NP
• TLC Counseling, LLC

• General Practice Dentistry in Little River, SC
• Providers in Little River, 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 Jul 13, 2026; 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.