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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC
NPI 1245737568
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in Clemmons, NC

Active since April 12, 2018CLIA 34D2299956 · Waiver
6318 JESSIE LN, CLEMMONS, NC 27012(336) 448-3060(336) 565-2400 Get Directions Write a Review

NPPES record last updated: July 2, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 5, 2019, Apr 12, 2018 (2 updates tracked since 2018).

About Triad Ocular And Facial Plastic Surgery Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC (NPI 1245737568) is a healthcare organization registered as an ophthalmic plastic and reconstructive surgery in Clemmons, North Carolina and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through February 28, 2028 and lists Molly Lynn Fuller, Owner, as its authorized official.

NPPES Registry Identity

NPI1245737568
Entity TypeOrganization
Primary Taxonomy207WX0200X
Legal Business NameTRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC
Location Address6318 JESSIE LNClemmons, NC 27012-9887
Mailing Address5335 Robinhood Village Dr # 178Winston Salem, NC 27106-9820 · (336) 448-3060
Phone(336) 448-3060
Fax(336) 565-2400
Organization SubpartNo
Authorized OfficialMolly Lynn FullerOwner · (336) 448-3060
Enumeration DateApril 12, 2018
Last NPPES UpdateJuly 2, 20262 updates tracked since enumeration
NPPES CertifiedJuly 2, 2026
✔ NPI 1245737568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Ophthalmic Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207WX0200X
License✔ Licensed in NC · 2015-01115
Definition

A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.

Also ListedPlastic Surgery · Plastic Surgery Within the Head and NeckTaxonomy 2082S0099X · License 2015-01115 (NC)
6318 JESSIE LN, Clemmons, NC 27012
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2299956

Triad Ocular And Facial Plastic Surgery · Clemmons, NC
Active · expires Feb 28, 2028
CLIA Number34D2299956
Laboratory TypeOffic Based Surgery Cente
Certificate Effective DateFebruary 28, 2026
Certificate Expiration DateFebruary 28, 2028
Laboratory DirectorMolly L. Fuller
Laboratory Phone(336) 448-3060
Laboratory LocationTriad Ocular And Facial Plastic Surgery6318 Jessie Ln, Clemmons, NC 27012
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ELISA A STEIN MD
Plastic Surgery
6318 JESSIE LN
CLEMMONS, NC 27012
Forsyth County (336) 355-0353
STEIN AESTHETIC & PLASTIC SURGERY
Plastic Surgery
6318 JESSIE LN
CLEMMONS, NC 27012
Forsyth County (336) 355-0353
DR. MOLLY LYNN FULLER M.D., PH.D.
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
6318 JESSIE LN
CLEMMONS, NC 27012
Forsyth County (336) 448-3060
TRIAD SURGICAL ARTS PLLC
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
6318 JESSIE LN
CLEMMONS, NC 27012
Forsyth County (336) 448-3060

Frequently Asked Questions

What is TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1245737568, enumerated as an "organization" on April 12, 2018.

Where is the provider located?

The provider is located at 6318 JESSIE LN CLEMMONS, NC 27012 and the phone number is (336) 448-3060.

What is the provider's specialty?

Ophthalmology with taxonomy code 207WX0200X and a focus in Ophthalmic Plastic and Reconstructive Surgery.

What insurance does TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC accept?

The provider might be accepting Accepts: Blue Cross and Blue Shield of NC. Please consult your insurance carrier or call the provider to verify.