Individual provider Active NPI

Clara Michelle Kohlmetz, DDS

  • General Practice Dentistry
  • Winston Salem, NC
National Provider Identifier
1972388809
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13466 Issued in NC
Practice address
705 Coliseum Dr
Winston Salem, NC 27106-5312
Phone
(336) 721-7921
Fax
(336) 721-2011
NPI assigned
Aug 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 13466 NC Primary

Addresses

Primary practice location

705 Coliseum Dr
Winston Salem, NC 27106-5312

Mailing address

1 Penton Ridge CT
Greensboro, NC 27455-2444
Phone (469) 422-2497

Other practice location 1

201 N Dalton St
Madison, NC 27025-1903
Phone (336) 548-9678

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

LicenseStateTypeSpecialty
13466NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Londry, Modlin, Tucker II DDS PLLC General Practice CurrentSince Jun 15, 2025 Accepting new patients
Londry& Modlin V DDS PLLC General Practice PastSince Sep 1, 2023 Accepting new patients
William H. Lewis, Jr. DDS PA PastSince Sep 1, 2023 Accepting new patients
Ballinger and Ballinger DMD PLLC General Practice PastSince Jun 15, 2025 Accepting new patients

Locations

705 Coliseum Dr
Winston Salem, NC 27106
Phone (336) 721-7921

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1972388809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENTON RIDGE CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552444",
            "telephone_number": "469-422-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 COLISEUM DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065312",
            "telephone_number": "336-721-7921",
            "fax_number": "336-721-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 N Dalton St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "NC",
            "postal_code": "270251903",
            "country_code": "US",
            "telephone_number": "336-548-9678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHLMETZ",
        "first_name": "CLARA",
        "middle_name": "MICHELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.