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General NPI Number Information
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NPI Number | 1740107952
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Entity Type | Organization
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Legal Business Name | LD GROUP SOUTH LLC
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 4861 W 134TH ST STE A
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City | LEAWOOD
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State | KS
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Zip | 66209-7826
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Country | US
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Telephone | 913-341-0018
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Fax |
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Provider Business Mailing Address
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Address Line | 11551 GRANADA ST STE 200
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City | LEAWOOD
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State | KS
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Zip | 66211-1444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. LUKE JOLIFF
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Credential | DDS
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Telephone | 785-230-4795
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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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