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General NPI Number Information
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NPI Number | 1508733825
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Entity Type | Organization
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Legal Business Name | MODLIN & LONDRY XVI DDS LLC
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 244 LATITUDE LN STE 103
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City | LAKE WYLIE
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State | SC
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Zip | 29710-8125
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Country | US
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Telephone | 803-831-2171
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Fax |
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Provider Business Mailing Address
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Address Line | 19810 W CATAWBA AVE STE A1
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City | CORNELIUS
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State | NC
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Zip | 28031-4056
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Country | US
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Telephone | 704-780-4597
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Fax | 704-225-8291
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Authorized Official
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Title or Position | OWNER
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Name | RYAN LONDRY
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Credential | DDS
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Telephone | 919-270-6096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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