Divine Lash & Beauty Bar

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

DIVINE LASH & BEAUTY BAR

Practice address

10520 N Baehr Rd Ste M
Mequon, WI 53092-6701

Phone

(262) 417-8385

Fax

(414) 202-6350

NPI assigned

Mar 29, 2022

Organization subpart

No

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

Authorized official

Name

Ashley MooreNPI 1669122529

Title

Owner/Aestthetician

Phone

(414) 202-6350

Specialties & licenses 1

Addresses

Other names 2

• Divine Lash & Beauty Bar Other name
• Divine Luxury Bundles Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Moore, AESTHETICIAN

  • Prosthetic/Orthotic Supplier
  • Mequon, WI
  • NPI 1669122529
  NPD Authorized official

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1902546187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 N BAEHR RD STE M",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530926701",
            "telephone_number": "262-417-8385",
            "fax_number": "414-202-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 N BAEHR RD STE M",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530926701",
            "telephone_number": "262-417-8385",
            "fax_number": "414-202-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE LASH & BEAUTY BAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER/AESTTHETICIAN",
        "authorized_official_telephone_number": "414-202-6350"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Lash & Beauty Bar",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Divine Luxury Bundles",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Divine Luxury Bundles",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kenneth Arthur Diamond, PH.D.
• Kathleen R Dionne, M.S.
• Philip W Diperna, N.P.
• Jessica Dippel
• Diversified Health and Supportive Services LLC
• Divine Love LLC
• Divine Personal Care Agency
• Bia Djelmami-Hani, RD, HWC
• Andreas Doermann, MD
• Kellie Doll

• Prosthetic/Orthotic Supplier in Mequon, WI
• Providers in Mequon, WI by specialty
• Prosthetic/Orthotic Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.