Provider Demographics
NPI:1942552500
Name:EFOBI, TABITHA IKPECHUKWU (DMD)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:IKPECHUKWU
Last Name:EFOBI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6570 SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-8651
Mailing Address - Country:US
Mailing Address - Phone:757-831-6852
Mailing Address - Fax:
Practice Address - Street 1:6570 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27023-8651
Practice Address - Country:US
Practice Address - Phone:757-831-6852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9408122300000X
GA19425525001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist