# MODLIN & LONDRY XVII DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Triad Perio
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174466874
- **Authorized official:** JESSICA HUNTER (DIRECTOR OF NETWORK RELATIONS)
- **Authorized official phone:** (704) 780-4597

## Contact information

- **Practice address:** 203 BOULEVARD ST, HIGH POINT, NC 27262-4301
- **Practice address phone:** (336) 889-5466
- **Practice address fax:** (336) 889-6898
- **Mailing address:** 19810 W CATAWBA AVE STE C, CORNELIUS, NC 28031-4057
- **Mailing address phone:** (704) 780-4597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 04/09/2026
- **Last updated:** 04/09/2026