Provider Demographics
NPI:1922752195
Name:HAPPY 5 PLLC
Entity Type:Organization
Organization Name:HAPPY 5 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERREN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPPETS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:970-901-1889
Mailing Address - Street 1:1930 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-1984
Mailing Address - Country:US
Mailing Address - Phone:720-526-6936
Mailing Address - Fax:
Practice Address - Street 1:1930 MAIN ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-1984
Practice Address - Country:US
Practice Address - Phone:720-526-6936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty