Healthcare Provider Details

I. General information

NPI: 1578474300
Provider Name (Legal Business Name): THE LUXE SALON, ACADEMY AND HAIR RESTORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FAIR OAKS DR APT 4404
SAVANNAH GA
31406-1125
US

IV. Provider business mailing address

4831 AUGUSTA RD STE F
GARDEN CITY GA
31408-1761
US

V. Phone/Fax

Practice location:
  • Phone: 843-599-4685
  • Fax:
Mailing address:
  • Phone: 843-599-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL

VIII. Authorized Official

Name: NATASHLEY SMALL
Title or Position: HAIR LOSS SPECIALIST
Credential: MASTER COSMETOLOGIST
Phone: 843-599-4685