Active NPI
Omar Glover, DMD
- Periodontics
- High Point, NC
National Provider Identifier
1730036112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12322
- Practice address
- 203 Boulevard St
High Point, NC 27262-4301 - Phone
- (336) 889-5466
- NPI assigned
- Mar 13, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12322 | NC | Primary |
Addresses
Primary practice location
203 Boulevard St
High Point, NC 27262-4301
Mailing address
900 Hobbs Rd Apt 323
Greensboro, NC 27410-5011
Phone (704) 591-5204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12322 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modlin & Londry Xvii DDS PLLC | Periodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Oral and Maxillofacial Surgery (Dentist)
- High Point, NC
- NPI 1174466874
Periodontics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785196800000",
"number": "1730036112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 HOBBS RD APT 323",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274105011",
"telephone_number": "704-591-5204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 BOULEVARD ST",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272624301",
"telephone_number": "336-889-5466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "OMAR",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-03-13",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NC",
"license": "12322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in High Point, NC
- Glosso Speech, Language and Educational Services Inc
- Glosso Speech, Language and Educational Services, Inc.
- Glosso Speech, Language and Educational SVCS, Inc.
- Kenneth Glover
- Nicholas Patrick Glover, CRNA
- Randall Godette
- Kristen Suzich Godwin, MD
- John Morris Goeke, PH.D.
- Amy Elizabeth Coe Goins, LCSW
- Amber Lynn Gold, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.