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  5. KLEMENT FAMILY DENTAL, P.A.

KLEMENT FAMILY DENTAL, P.A.

Company Details

Entity Name: KLEMENT FAMILY DENTAL, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 10 Nov 1982 (42 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 07 Oct 2014 (10 years ago)
Document Number: G08573
FEI/EIN Number 59-2248461
Address: 7650 38TH AVENUE NORTH, ST PETERSBURG, FL 33710
Mail Address: 7650 38TH AVENUE NORTH, ST PETERSBURG, FL 33710
ZIP code: 33710
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1952932816 2020-01-30 2020-01-30 425 22ND AVENUE NORTH, SAINT PETERSBURG, FL, 33704, US 425 22ND AVENUE NORTH, SAINT PETERSBURG, FL, 33704, US

Contacts
Phone +1 727-498-7581

Authorized person
Name MR. STEPHEN MATTHEW KLEMENT
Role DENTIST/OWNER
Phone 7274987581

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2023 592248461 2024-10-23 KLEMENT FAMILY DENTAL P.A. 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2022 592248461 2023-10-10 KLEMENT FAMILY DENTAL P.A. 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2021 592248461 2022-09-19 KLEMENT FAMILY DENTAL P.A. 54
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2021 592248461 2023-10-09 KLEMENT FAMILY DENTAL P.A. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2020 592248461 2021-10-11 KLEMENT FAMILY DENTAL P.A. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2019 592248461 2020-07-28 KLEMENT FAMILY DENTAL P.A. 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2018 592248461 2019-06-21 KLEMENT FAMILY DENTAL P.A. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL, P.A. 401K PROFIT SHARING PLAN AND TRUST 2017 592248461 2018-10-14 KLEMENT FAMILY DENTAL P.A. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710
KLEMENT FAMILY DENTAL CARE, P.A. 401K PROFIT SHARING PLAN AND TRUST 2016 592248461 2017-06-28 KLEMENT FAMILY DENTAL P.A. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710

Signature of
Role Plan administrator
Date 2017-06-28
Name of individual signing E.C. KLEMENT
Valid signature Filed with authorized/valid electronic signature
KLEMENT FAMILY DENTAL CARE, P.A. 401K PROFIT SHARING PLAN AND TRUST 2015 592248461 2016-05-02 KLEMENT FAMILY DENTAL P.A. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 7273438831
Plan sponsor’s address 7650 38TH AVE. NORTH, ST. PETERSBURG, FL, 33710

Signature of
Role Plan administrator
Date 2016-05-02
Name of individual signing E.C. KLEMENT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
CHESTNUT BUSINESS SERVICES, LLC Agent

President

Name Role Address
KLEMENT, STEPHEN M., D.M.D. President 7650 38TH AVENUE NORTH, ST PETERSBURG, FL 33710

Director

Name Role Address
KLEMENT, STEPHEN M., D.M.D. Director 7650 38TH AVENUE NORTH, ST PETERSBURG, FL 33710

Chief Executive Officer

Name Role Address
Klement, Elizabeth C, Phd Chief Executive Officer 7650 38TH AVENUE NORTH, ST PETERSBURG, FL 33710

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000124780 KLEMENT FAMILY DENTAL ACTIVE 2014-12-12 2029-12-31 No data 7650 38TH AVENUE NORTH, ST. PETERSBURG, FL, 33710
G09000110583 KLEMENT FAMILY DENTAL CARE EXPIRED 2009-05-26 2024-12-31 No data 7650 38TH AVENUE NORTH, ST PETERSBURG, FL, 33710

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2019-11-26 CHESTNUT BUSINESS SERVICES, LLC No data
REGISTERED AGENT ADDRESS CHANGED 2019-11-26 333 3rd Avenue North, Suite 200, St. Petersburg, FL 33701 No data
NAME CHANGE AMENDMENT 2014-10-07 KLEMENT FAMILY DENTAL, P.A. No data
NAME CHANGE AMENDMENT 2009-03-16 KLEMENT FAMILY DENTAL CARE, P.A. No data
NAME CHANGE AMENDMENT 2003-10-13 KLEMENT DENTAL EXCELLENCE, P.A. No data
CHANGE OF PRINCIPAL ADDRESS 1996-08-05 7650 38TH AVENUE NORTH, ST PETERSBURG, FL 33710 No data
CHANGE OF MAILING ADDRESS 1996-08-05 7650 38TH AVENUE NORTH, ST PETERSBURG, FL 33710 No data
NAME CHANGE AMENDMENT 1996-08-05 KLEMENT DENTAL ASSOCIATES, P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-04-03
ANNUAL REPORT 2023-04-10
ANNUAL REPORT 2022-05-02
ANNUAL REPORT 2021-04-20
ANNUAL REPORT 2020-06-17
AMENDED ANNUAL REPORT 2019-11-26
ANNUAL REPORT 2019-04-24
ANNUAL REPORT 2018-03-28
ANNUAL REPORT 2017-04-24
ANNUAL REPORT 2016-03-15

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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