Mejestic Hair Luxury Wigs & Extensions LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MEJESTIC HAIR LUXURY WIGS & EXTENSIONS LLC

Doing business as

Prosthetic Orthotic Provider

Practice address

329 Manhattan Dr
Burlington, VT 05401-5544

Phone

(386) 991-1109

Fax

(802) 419-4847

NPI assigned

Feb 24, 2022

Organization subpart

No

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

Authorized official

Name

Nakima Venise Mercer

Title

Owner

Phone

(386) 991-1109

Specialties & licenses 1

Addresses

Other names 1

• Prosthetic Orthotic Provider Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1164178505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 S WINOOSKI AVE UNIT 298",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013898",
            "telephone_number": "386-991-1109",
            "fax_number": "802-419-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 MANHATTAN DR",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015544",
            "telephone_number": "386-991-1109",
            "fax_number": "802-419-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEJESTIC HAIR LUXURY WIGS & EXTENSIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "MERCER",
        "authorized_official_first_name": "NAKIMA",
        "authorized_official_middle_name": "VENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-991-1109"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "802-419-4847",
            "affiliation": "N",
            "endpointDescription": "386-991-1109",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "fax",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "phone",
            "address_1": "329 Manhattan Dr",
            "city": "Burlington",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054015544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Prosthetic Orthotic Provider",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Burlington, VT
• Providers in Burlington, VT by specialty
• Prosthetic/Orthotic Supplier in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.