Provider Demographics
NPI:1780560565
Name:MODLIN & LONDRY XV DDS PLLC
Entity type:Organization
Organization Name:MODLIN & LONDRY XV DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LONDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-997-8878
Mailing Address - Street 1:19180 W CATAWBA AVE
Mailing Address - Street 2:STE. C
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4057
Mailing Address - Country:US
Mailing Address - Phone:704-997-8878
Mailing Address - Fax:
Practice Address - Street 1:1030 MCKEE FARM LN
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-8687
Practice Address - Country:US
Practice Address - Phone:704-829-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty