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  5. WILLIAM B. NIPPER, JR., D.M.D., P.A.

WILLIAM B. NIPPER, JR., D.M.D., P.A.

Company Details

Entity Name: WILLIAM B. NIPPER, JR., D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 01 Nov 1980 (44 years ago)
Date of dissolution: 25 Sep 2015 (9 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (9 years ago)
Document Number: F04733
FEI/EIN Number 59-2033992
Address: 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073
Mail Address: 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073
ZIP code: 32073
County: Clay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1538274469 2006-08-20 2010-08-12 1414 KINGSLEY AVE, SUITE 1, ORANGE PARK, FL, 320734591, US 1414 KINGSLEY AVE, SUITE 1, ORANGE PARK, FL, 320734591, US

Contacts
Phone +1 904-269-4201
Fax 9042691163

Authorized person
Name DR. WILLIAM B. NIPPER JR.
Role PRESIDENT
Phone 9042694201

Taxonomy
Taxonomy Code 1223E0200X - Endodontist
License Number DN 6934
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROFIT SHARING PLAN AND TRUST AGREEMENT OF WILLIAM B. NIPPER, JR., D.M.D., P.A. 2014 592033992 2015-10-07 WILLIAM B. NIPPER, JR., D.M.D., P.A 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621111
Sponsor’s telephone number 9042694201
Plan sponsor’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 592033992
Plan administrator’s name WILLIAM B. NIPPER, JR., D.M.D., P.A
Plan administrator’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042694201

Signature of
Role Plan administrator
Date 2015-10-07
Name of individual signing WILLIAM B. NIPPER, JR., D.M.D.
Valid signature Filed with authorized/valid electronic signature
PROFIT SHARING PLAN AND TRUST AGREEMENT OF WILLIAM B. NIPPER, JR., D.M.D., P.A. 2013 592033992 2014-10-07 WILLIAM B. NIPPER, JR., D.M.D., P.A 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621111
Sponsor’s telephone number 9042694201
Plan sponsor’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 592033992
Plan administrator’s name WILLIAM B. NIPPER, JR., D.M.D., P.A
Plan administrator’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042694201

Signature of
Role Plan administrator
Date 2014-10-07
Name of individual signing WILLIAM B. NIPPER, JR., D.M.D.
Valid signature Filed with authorized/valid electronic signature
PROFIT SHARING PLAN AND TRUST AGREEMENT OF WILLIAM B. NIPPER, JR., D.M.D., P.A. 2012 592033992 2013-10-04 WILLIAM B. NIPPER, JR., D.M.D., P.A 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621111
Sponsor’s telephone number 9042694201
Plan sponsor’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2013-10-04
Name of individual signing WILLIAM B. NIPPER, JR., D.M.D.
Valid signature Filed with authorized/valid electronic signature
PROFIT SHARING PLAN AND TRUST AGREEMENT OF WILLIAM B. NIPPER, JR., D.M.D., P.A. 2011 592033992 2012-10-08 WILLIAM B. NIPPER, JR., D.M.D., P.A 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621111
Sponsor’s telephone number 9042694201
Plan sponsor’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 592033992
Plan administrator’s name WILLIAM B. NIPPER, JR., D.M.D., P.A
Plan administrator’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042694201

Signature of
Role Plan administrator
Date 2012-10-05
Name of individual signing WILLIAM B NIPPER JR DMD
Valid signature Filed with authorized/valid electronic signature
PROFIT SHARING PLAN AND TRUST AGREEMENT OF WILLIAM B NIPPER JR DMD PA 2010 592033992 2011-10-10 WILLIAM B NIPPER, JR , D M D , P A 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621111
Sponsor’s telephone number 9042694201
Plan sponsor’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 592033992
Plan administrator’s name WILLIAM B NIPPER JR D M D P A
Plan administrator’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042694201

Signature of
Role Plan administrator
Date 2011-10-10
Name of individual signing WILLIAM B NIPPER JR DMD
Valid signature Filed with authorized/valid electronic signature
PROFIT SHARING PLAN AND TRUST AGREEMENT OF WILLIAM B NIPPER JR DMD PA 2009 592033992 2010-07-27 WILLIAM B NIPPER, JR , D M D , P A 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621111
Sponsor’s telephone number 9042694201
Plan sponsor’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 592033992
Plan administrator’s name WILLIAM B NIPPER JR D M D P A
Plan administrator’s address 1414 KINGSLEY AVENUE SUITE 1, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042694201

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing WILLIAM B NIPPER JR DMD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
NIPPER, WILLIAM BJR. Agent 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073

President

Name Role Address
NIPPER, WILLIAM BJR. President 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073

Director

Name Role Address
NIPPER, WILLIAM BJR. Director 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000014016 ORANGE PARK ENDODONTICS EXPIRED 2012-02-09 2017-12-31 No data 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL, 32073

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
REINSTATEMENT 1999-05-19 No data No data
CHANGE OF PRINCIPAL ADDRESS 1999-05-19 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073 No data
CHANGE OF MAILING ADDRESS 1999-05-19 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073 No data
REGISTERED AGENT ADDRESS CHANGED 1999-05-19 1414 KINGSLEY AVENUE, SUITE 1, ORANGE PARK, FL 32073 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 1998-10-16 No data No data

Documents

Name Date
ANNUAL REPORT 2014-01-15
ANNUAL REPORT 2013-01-29
ANNUAL REPORT 2012-01-18
ANNUAL REPORT 2011-01-11
ANNUAL REPORT 2010-03-11
ANNUAL REPORT 2009-01-21
ANNUAL REPORT 2008-03-05
ANNUAL REPORT 2007-02-05
ANNUAL REPORT 2006-03-21
ANNUAL REPORT 2005-03-15

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 05 Feb 2025

Sources: Florida Department of State

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