Londry, Modlin, Tucker V DDS PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LONDRY, MODLIN, TUCKER V DDS PLLC

Doing business as

Lewisville Pediatric Dentistry

Practice address

6570 Shallowford Rd Ste 110
Lewisville, NC 27023-8651

Phone

(704) 997-8878

NPI assigned

Nov 13, 2024

Last updated

Nov 13, 2024By 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

Lisa Travis

Title

Director of Finance

Phone

(704) 997-8878

Specialties & licenses 1

Addresses

Other names 1

• Lewisville Pediatric Dentistry Doing business as

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1831913037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20311 CHARTWELL CENTER DR.",
            "address_2": "PO BOX 2127",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "28031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6570 SHALLOWFORD RD STE 110",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270238651",
            "telephone_number": "704-997-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONDRY, MODLIN, TUCKER V DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "TRAVIS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "704-997-8878"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewisville Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lewisville Optical Inc
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• Liner, Ward & Shobe DDS, PA (Southern Dental Associates)
• Kimberly Jean Lis, MD
• Jennifer B Locklear, NCC, LPCS, LCAS, CSI
• Love Still Matter Homecare, LLC
• Ryan Phillip Macdonald
• Sarah Macreynolds, LCSW
• Sara James Migliarese, PT, MS, NCS
• Sharon Johnson Montecalvo, MA, LPC

• Pediatric Dentistry in Lewisville, NC
• Providers in Lewisville, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.