Ejuan Davis, HAIR LOSS SPECIALIST

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Practice address

5043 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2733

Phone

(404) 834-0396

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Ejuan Davis Smallwood Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Ejuan Hair Replacement Center

  • Durable Medical Equipment & Medical Supplies
  • Hiram, GA
  • NPI 1528587656

  Specialist

  NPD (past)

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437676244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CENTENNIAL LN",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320256",
            "telephone_number": "404-834-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5043 JIMMY LEE SMITH PKWY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412733",
            "telephone_number": "404-834-0396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Centennial Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301320256",
            "country_code": "US",
            "telephone_number": "404-834-0396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EJUAN",
        "name_prefix": "Ms.",
        "credential": "HAIR LOSS SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EJUAN",
            "last_name": "SMALLWOOD",
            "middle_name": "DAVIS",
            "prefix": "MISS",
            "credential": "HLS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dante C Daniel, PHARMD
• Jhalil Daniels
• Shannon Davidson, LCSW
• Celeste Davis, LPC
• Deborah Wickham Davis, PT
• Shirtia Davis
• Dawning Journeys Counseling, LLC
• Kendrah Degruy
• Rachel Marie Deloach, PHARMD
• Carrie N Deloughy, FNP

• Prosthetics Case Management in Hiram, GA
• Providers in Hiram, GA by specialty
• Prosthetics Case Management in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.