NPIMap

Organization Active NPI

Enchanted Essence Beauty Boutique LLC

  • Prosthetic/Orthotic Supplier
  • Reno, NV
National Provider Identifier
1932897113
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
ENCHANTED ESSENCE BEAUTY BOUTIQUE LLC
Doing business as
Enchanted Essence Beauty Boutique Salon & Hair Restoration Center
Practice address
3710 Grant Dr Ste a
Reno, NV 89509-5317
Phone
(775) 786-0884
NPI assigned
Apr 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Mrs. Latosha JacksonNPI 1215631676
Title
Owner
Phone
(775) 770-8023

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

3710 Grant Dr Ste a
Reno, NV 89509-5317

Mailing address

3710 Grant Dr Ste a
Reno, NV 89509-5317
Phone (775) 786-0884

Other names 3

  • Enchanted Essence Beauty Boutique Salon & Hair Restoration Center Doing business as
  • Enchanted Essence Beauty Boutique Other name
  • Enchanted Essence Beauty Boutique Salon & Restoration Center Other name

National Provider Directory

National Provider Directory

Locations

3710 Grant Dr
Ste A
Reno, NV 89509
Phone (775) 786-0884

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": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1932897113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 GRANT DR STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895095317",
            "telephone_number": "775-786-0884",
            "fax_number": "775-600-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 GRANT DR STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895095317",
            "telephone_number": "775-786-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCHANTED ESSENCE BEAUTY BOUTIQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LATOSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-770-8023",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "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": "Enchanted Essence Beauty Boutique Salon & Hair Restoration Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Enchanted Essence Beauty Boutique",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Enchanted Essence Beauty Boutique Salon & Restoration Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.