Organization Active NPI

Debonair Salon LLC

  • Other Technician
  • Jacksonville, FL
National Provider Identifier
1336905058
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Legal business name
DEBONAIR SALON LLC
Doing business as
Debonair Salon LLC
Practice address
1400 Cassat Ave Ste 1
Jacksonville, FL 32205-7245
Phone
(904) 539-7237
NPI assigned
Feb 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Shantoria LoweNPI 1134995723
Title
Salon Manager
Phone
(904) 539-7237

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 247200000X Primary

Addresses

Primary practice location

1400 Cassat Ave Ste 1
Jacksonville, FL 32205-7245

Mailing address

1400 Cassat Ave Ste 1
Jacksonville, FL 32205-7245
Phone (904) 539-7237

Other names 1

  • Debonair Salon LLC Doing business as

National Provider Directory

National Provider Directory

Locations

1400 Cassat Ave
Ste 1
Jacksonville, FL 32205
Phone (904) 539-7237

5301 Norwood Ave
Ste 14
Jacksonville, FL 32208

1485 N Myrtle Ave
Jacksonville, FL 32209

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1336905058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CASSAT AVE STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057245",
            "telephone_number": "904-539-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CASSAT AVE STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057245",
            "telephone_number": "904-539-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBONAIR SALON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "SHANTORIA",
        "authorized_official_title_or_position": "SALON MANAGER",
        "authorized_official_telephone_number": "904-539-7237"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Debonair Salon LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.