Kennesaw Luxary Hair Boutique

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

KENNESAW LUXARY HAIR BOUTIQUE

Practice address

3555 Sanderlings Pointe NW
Kennesaw, GA 30152-5822

Phone

(678) 873-5853

NPI assigned

Nov 13, 2018

Last updated

Nov 13, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Cook Griffin

Title

Owner

Phone

(770) 427-7887

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1063981678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 SANDERLINGS POINTE NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301525822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 SANDERLINGS POINTE NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301525822",
            "telephone_number": "678-873-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNESAW LUXARY HAIR BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "COOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-427-7887"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kennesaw Mountain Dental Associates
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• Specialist in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.