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General NPI Number Information
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NPI Number | 1881564458
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Entity Type | Organization
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Legal Business Name | LONDRY & MODLIN XVIII DDS PLLC
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 3809 FORRESTGATE DR STE A
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City | WINSTON SALEM
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State | NC
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Zip | 27103-2982
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Country | US
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Telephone | 743-255-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 19810 W CATAWBA AVE NUM 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 | 743-255-8011
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF NETWORK RELATIONS
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Name | JESSICA HUNTER
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Credential |
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Telephone | 704-780-4597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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