Theodros a. Abraha DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

8332 Issued in NC

Legal business name

THEODROS A. ABRAHA DDS PC

Doing business as

Abraha Family Dentistry

Practice address

4201 University Dr Ste 109
Durham, NC 27707-2533

Phone

(919) 294-4234

NPI assigned

Mar 23, 2016

Last updated

Mar 23, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theodros Araya Abraha, DDS

Title

President

Phone

(919) 294-4234

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Abraha Family Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mayada Khidr

  • Dentist
  • Durham, NC
  • NPI 1740627090
  NPD (past)

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1053773614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 UNIVERSITY DR STE 109",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072533",
            "telephone_number": "919-294-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 UNIVERSITY DR STE 109",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072533",
            "telephone_number": "919-294-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODROS A. ABRAHA DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "ABRAHA",
        "authorized_official_first_name": "THEODROS",
        "authorized_official_middle_name": "ARAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-294-4234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906536",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abraha Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Durham, NC
• Providers in Durham, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.