Healthcare Provider Details

I. General information

NPI: 1235040585
Provider Name (Legal Business Name): ABRAHA & KHIDR DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 S BECKFORD DR
HENDERSON NC
27536-5950
US

IV. Provider business mailing address

895 S BECKFORD DR STE B
HENDERSON NC
27536-5950
US

V. Phone/Fax

Practice location:
  • Phone: 252-492-8080
  • Fax: 252-438-6105
Mailing address:
  • Phone: 252-492-8080
  • Fax: 252-438-6105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: THEODROS ABRAHA
Title or Position: OWNER
Credential: DDS
Phone: 919-452-6365