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General NPI Number Information
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NPI Number | 1033738117
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Entity Type | Organization
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Legal Business Name | LDW, LLC
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 8972 DARROW RD
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City | TWINSBURG
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State | OH
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Zip | 44087-2189
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Country | US
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Telephone | 510-457-5270
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Fax |
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Provider Business Mailing Address
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Address Line | 154 E AURORA RD # 344
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City | NORTHFIELD
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State | OH
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Zip | 44067-2053
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Country | US
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Telephone | 510-457-5270
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHARON THOMAS OKEZIE
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Credential | DDS
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Telephone | 510-457-5270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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