Custom Wig World 4 Kids

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CUSTOM WIG WORLD 4 KIDS

Practice address

9270 Quarterhorse LN Unit 404
Las Vegas, NV 89178-6344

Phone

(949) 295-1503

NPI assigned

May 31, 2024

Organization subpart

No

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

Authorized official

Name

Antoinette Laster-SmithNPI 1699515106

Title

Owner

Phone

(949) 295-1503

Specialties & licenses 1

Addresses

Practitioners 1

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

• Antoinette Laster-Smith

  • Prosthetics Case Management
  • Las Vegas, NV
  • NPI 1699515106
  NPD Authorized official

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1740020254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9270 QUARTERHORSE LN UNIT 404",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891786344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9270 QUARTERHORSE LN UNIT 404",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891786344",
            "telephone_number": "949-295-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM WIG WORLD 4 KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "LASTER-SMITH",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-295-1503"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammie Cushman, RN
• Karla Custodio
• Leona Jane Custodio
• Magdalena Custodio
• Ricardo Custodio
• William Cuthbertson Sr., NAT. CERTIFIED COUNS
• Dayssi Leanet Cutie Chaveco, RN
• Bernardo Cutie
• Larisa Cutie
• Olivia Cutinha

• Durable Medical Equipment & Medical Supplies in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.