Triad Ocular and Facial Plastic Surgery PLLC

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

2015-01115 Issued in NC

Legal business name

TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC

Practice address

6318 Jessie LN
Clemmons, NC 27012-9887

Phone

(336) 448-3060

Fax

(336) 565-2400

NPI assigned

Apr 12, 2018

Last updated

Jul 2, 2026By 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

Molly Lynn Fuller, MD, PHDNPI 1326276577

Title

Owner

Phone

(336) 448-3060

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21596/brand/1/csg/1/fhir/r4

Practitioners 3

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.

• Molly Lynn Fuller, M.D., PH.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Clemmons, NC
  • NPI 1326276577
  Medicare reassignment Care Compare group NPD Authorized official
• Anthony Presley Leonard, M.D., PH.D.

  • Ophthalmology Physician
  • Greensboro, NC
  • NPI 1619327434

  Ophthalmic Plastic and Reconstructive Surgery

  Medicare reassignment Care Compare group NPD
• David Wesley Parker II, M.D., D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Bermuda Run, NC
  • NPI 1316277676
  NPD (past)

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1245737568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5335 ROBINHOOD VILLAGE DR # 178",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271069820",
            "telephone_number": "336-448-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6318 JESSIE LN",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129887",
            "telephone_number": "336-448-3060",
            "fax_number": "336-565-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-448-3060",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "2015-01115",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NC",
            "license": "2015-01115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaozhou Ken Tian, M.D.
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• Donna C Trainer
• Triad Nurse Concierge PLLC
• Triad Orthotics and Pedorthics Inc.
• Triad Pediatric Eye Physicians PC
• Triad Surgical Arts PLLC
• Amelia Beck Trinkle
• Ishik C Tuna, M.D.

• Ophthalmic Plastic and Reconstructive Surgery Physician in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.