| Entity Name: | SAFARI SMILES CHILDREN DENTISTRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Jul 2024 (7 months ago) |
| Document Number: | L24000307556 |
| Address: | 8951 BONITA BEACH ROAD, SE, 220, BONITA SPRINGS, FL, 34135 |
| Mail Address: | 8951 BONITA BEACH ROAD, SE, 220, BONITA SPRINGS, FL, 34135 |
| ZIP code: | 34135 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164259511 | 2024-09-18 | 2024-09-18 | 8951 BONITA BEACH RD SE STE 220, BONITA SPRINGS, FL, 341354202, US | 8951 BONITA BEACH RD SE STE 220, BONITA SPRINGS, FL, 341354202, US | |||||||||||||
|
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| Phone | +1 239-471-4005 |
Authorized person
| Name | JONATHAN VAN DYKE |
| Role | OWNER |
| Phone | 2536775402 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FAIRBANKS JENNIFER LESQ. | Agent | 2222 SECOND STREET, FORT MYERS, FL, 33901 |
| Name | Role | Address |
|---|---|---|
| DADKHAH MARC | Manager | 9074 BEXLEY DRIVE, FORT MYERS, FL, 33967 |
| VAN DYKE JONATHAN | Manager | 606 BALD EAGLE DRIVE,, MARCO ISLAND, FL, 34145 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000095326 | SAFARI SMILES CHILDREN'S DENTISTRY | ACTIVE | 2024-08-10 | 2029-12-31 | No data | 8951 BONITA BEACH RD SE STE 220, BONITA SPRINGS, FL, 34135 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-07-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
