Lori Beth Porras, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9567 Issued in SC

Practice address

4603 Oleander Dr Ste 3
Myrtle Beach, SC 29577-5738

Phone

(843) 353-3319

Fax

(843) 353-3238

NPI assigned

Jul 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Little Waves Pediatric Dentistry

  • Pediatric Dentistry
  • Myrtle Beach, SC
  • NPI 1336917145
  NPD Authorized official

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1750636569",
    "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",
            "telephone_number": "954-383-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 OLEANDER DR STE 3",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775738",
            "telephone_number": "843-353-3319",
            "fax_number": "843-353-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRAS",
        "first_name": "LORI",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 19624",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "9567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda R Pomeroy
• Desmond Recardo Ponder, MD
• Jacob Daniel Pope, D.O.
• Courtney Lynn Porfilio-Stitt, PA-C
• Benjamin Eric Porras, D.M.D.
• Christian Michael Porter, PA-C
• Eleah D. Porter, M.D.
• Sarah Porter, LMT
• Veronika Porter
• Sarah Posen

• Pediatric Dentistry in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.