Provider Demographics
NPI:1841778164
Name:SHIPPEE, REBECCA HANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:HANA
Last Name:SHIPPEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757 OAKBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-3406
Mailing Address - Country:US
Mailing Address - Phone:954-816-6722
Mailing Address - Fax:
Practice Address - Street 1:1700 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8970
Practice Address - Country:US
Practice Address - Phone:954-344-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23257122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist