Provider Demographics
NPI:1508233305
Name:HAPPY KIDS PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:HAPPY KIDS PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRUZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:CEINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-887-5437
Mailing Address - Street 1:7715 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4715
Mailing Address - Country:US
Mailing Address - Phone:813-887-5437
Mailing Address - Fax:
Practice Address - Street 1:7715 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4715
Practice Address - Country:US
Practice Address - Phone:813-887-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN178601223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1801991732Medicaid
FL1831326974Medicaid