Individual provider Active NPI

Addie Milam Luff

  • Dentist
  • Lees Summit, MO
National Provider Identifier
1871151316
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2019020542 Issued in MO
Practice address
688 SE Bayberry LN Ste 101
Lees Summit, MO 64063-4392
Phone
(816) 875-3391
Fax
(816) 343-5262
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2019020542 MO Primary

Addresses

Primary practice location

688 SE Bayberry LN Ste 101
Lees Summit, MO 64063-4392

Mailing address

688 SE Bayberry LN Ste 101
Lees Summit, MO 64063-4392
Phone (816) 875-3391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2019020542MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Luff Dental LLC CurrentSince Jun 4, 2023 Accepting new patients

Locations

688 SE Bayberry Ln
Ste 101
Lees Summit, MO 64063
Phone (816) 525-5257

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1871151316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 SE BAYBERRY LN STE 101",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634392",
            "telephone_number": "816-875-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 SE BAYBERRY LN STE 101",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634392",
            "telephone_number": "816-875-3391",
            "fax_number": "816-343-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUFF",
        "first_name": "ADDIE",
        "middle_name": "MILAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2019020542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.