Luxe Medical Wigs LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

LUXE MEDICAL WIGS LLC

Doing business as

Luxe Medical Cranial Prosthetics

Practice address

1609 Blue Ridge Ter
Columbia, SC 29203-1711

Phone

(470) 606-6050

NPI assigned

Nov 12, 2025

Last updated

Apr 6, 2026By 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

Demazada Gary

Title

Owner/Cranial Prothesis Specialist

Phone

(470) 606-6050

Specialties & licenses 2

Addresses

Other names 1

• Luxe Medical Cranial Prosthetics Doing business as

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1750241824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 ASHLAND DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298414",
            "telephone_number": "470-606-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 BLUE RIDGE TER",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292031711",
            "telephone_number": "470-606-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXE MEDICAL WIGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "GARY",
        "authorized_official_first_name": "DEMAZADA",
        "authorized_official_title_or_position": "OWNER/CRANIAL PROTHESIS SPECIALIST",
        "authorized_official_telephone_number": "470-606-6050"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luxe Medical Cranial Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kassandra Luttrull, RBT
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• Prosthetic/Orthotic Supplier in Columbia, SC
• Providers in Columbia, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.