Healthcare Provider Details

I. General information

NPI: 1023836194
Provider Name (Legal Business Name): DHCK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2024
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 S POINTE BLVD STE 109
FORT MYERS FL
33919-3273
US

IV. Provider business mailing address

5995 S POINTE BLVD STE 109
FORT MYERS FL
33919-3273
US

V. Phone/Fax

Practice location:
  • Phone: 239-286-9988
  • Fax: 239-737-2869
Mailing address:
  • Phone: 239-286-9988
  • Fax: 239-737-2869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER L DARIA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 239-286-9988