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  5. ORRIN D. MITCHELL, D.D.S., P.A.

ORRIN D. MITCHELL, D.D.S., P.A.

Company Details

Entity Name: ORRIN D. MITCHELL, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 01 Oct 1978 (46 years ago)
Document Number: 588203
FEI/EIN Number 591847618
Address: 1190-A WEST EDGEWOOD AVE., SUITE A, JACKSONVILLE, FL, 32208
Mail Address: 1190-A WEST EDGEWOOD AVE., SUITE A, JACKSONVILLE, FL, 32208
ZIP code: 32208
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1013288943 2012-01-24 2013-03-27 1190 EDGEWOOD AVE W, SUITE A, JACKSONVILLE, FL, 322083419, US 10920 BAYMEADOWS RD, SUITE 14, JACKSONVILLE, FL, 322564570, US

Contacts
Phone +1 904-766-6000
Fax 9047666003
Phone +1 904-538-9300
Fax 9045839350

Authorized person
Name DR. ORRIN D MITCHELL
Role OWNER
Phone 9045389300

Taxonomy
Taxonomy Code 261QD0000X - Dental Clinic/Center
License Number DN 6224
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORRIN D. MITCHELL, D.D.S., P.A. DEFINED BENEFIT PLAN 2011 591847618 2013-01-29 ORRIN D. MITCHELL, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-10-01
Business code 621210
Sponsor’s telephone number 9047666000
Plan sponsor’s address 1190 W. EDGEWOOD BLVD., STE A, JACKSONVILLE, FL, 322083419

Plan administrator’s name and address
Administrator’s EIN 591847618
Plan administrator’s name ORRIN D. MITCHELL, D.D.S., P.A.
Plan administrator’s address 1190 W. EDGEWOOD BLVD., STE A, JACKSONVILLE, FL, 322083419
Administrator’s telephone number 9047666000

Signature of
Role Plan administrator
Date 2013-01-29
Name of individual signing ORRIN D. MITCHELL
Valid signature Filed with authorized/valid electronic signature
ORRIN D. MITCHELL, D.D.S., P.A. DEFINED BENEFIT PLAN 2010 591847618 2012-05-14 ORRIN D. MITCHELL, D.D.S., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-10-01
Business code 621210
Sponsor’s telephone number 9047666000
Plan sponsor’s address 1190 W. EDGEWOOD BLVD., STE A, JACKSONVILLE, FL, 322083419

Plan administrator’s name and address
Administrator’s EIN 591847618
Plan administrator’s name ORRIN D. MITCHELL, D.D.S., P.A.
Plan administrator’s address 1190 W. EDGEWOOD BLVD., STE A, JACKSONVILLE, FL, 322083419
Administrator’s telephone number 9047666000

Signature of
Role Plan administrator
Date 2012-05-14
Name of individual signing ORRIN D. MITCHELL, D.D.S.
Valid signature Filed with authorized/valid electronic signature
ORRIN D. MITCHELL, D.D.S., P.A. DEFINED BENEFIT PLAN 2009 591847618 2011-07-13 ORRIN D. MITCHELL, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-10-01
Business code 621210
Sponsor’s telephone number 9047666000
Plan sponsor’s address 1190 W. EDGEWOOD BLVD., STE A, JACKSONVILLE, FL, 322083419

Plan administrator’s name and address
Administrator’s EIN 591847618
Plan administrator’s name ORRIN D. MITCHELL, D.D.S., P.A.
Plan administrator’s address 1190 W. EDGEWOOD BLVD., STE A, JACKSONVILLE, FL, 322083419
Administrator’s telephone number 9047666000

Signature of
Role Plan administrator
Date 2011-07-12
Name of individual signing ORRIN D. MITCHELL, D.D.S.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MITCHELL, ORRIN D. Agent 1190-A W. EDGEWOOD AVE., JACKSONVILLE, FL, 32208

President

Name Role Address
MITCHELL, ORRIN D.,D.D.S President 1190-A W. EDGEWOOD AVE., JACKSONVILLE, FL, 32208

Director

Name Role Address
MITCHELL, ORRIN D.,D.D.S Director 1190-A W. EDGEWOOD AVE., JACKSONVILLE, FL, 32208

Secretary

Name Role Address
MITCHELL, PATRICIA Secretary 1190-A W. EDGEWOOD AVE., JACKSONVILLE, FL, 32208

Treasurer

Name Role Address
MITCHELL, PATRICIA Treasurer 1190-A W. EDGEWOOD AVE., JACKSONVILLE, FL, 32208

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G07082900236 JACKSONVILLE ORTHODONTICS ACTIVE 2007-03-23 2027-12-31 No data 1190 W. EDGEWOOD AVE., SUITE A, JACKSONVILLE, FL, 32208

Related by officers

MITCHELL, PATRICIA

DIGNITY BED LLC B2B INTERNET SERVICES, LLC BLACKMAN MILLER INC. OPTIONS HEALTH FAMILY PRACTICE, LLC TRISH MITCHELL TRAVEL LLC MINTOC MINORITY TECHNICAL CORPORATION LOVE MINISTRIES, INC. THE BEACH COLONY MOTEL OF PANAMA CITY BEACH, INC. TNT ENTERPRISES, LLC MITCHELL PAINT IT, INC.

MITCHELL, ORRIN D.

THE MSN OFFICE PARK ASSOCIATION, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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