Healthcare Provider Details

I. General information

NPI: 1013720895
Provider Name (Legal Business Name): ABEER ALKHALDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 SIXES RD
CANTON GA
30114-7801
US

IV. Provider business mailing address

601 ALBANY ST UNIT 301
BOSTON MA
02118-2790
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-0966
  • Fax:
Mailing address:
  • Phone: 404-422-0966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124018
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: