| Entity Name: | LARRY D. BURNSIDE, D.D.S., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 09 May 1983 (42 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 16 Apr 2011 (14 years ago) |
| Document Number: | G37491 |
| FEI/EIN Number | 59-2298758 |
| Address: | 12708-3 SAN JOSE BLVD, JACKSONVILLE, FL 32223 |
| Mail Address: | 205 E Kari Court, Saint Johns, FL 32259 |
| ZIP code: | 32223 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861563041 | 2006-11-10 | 2020-08-22 | 711 CREIGHTON RD, ORANGE PARK, FL, 320037008, US | 12708 SAN JOSE BLVD, JACKSONVILLE, FL, 322232689, US | |||||||||||||||||||||
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| Phone | +1 904-264-2759 |
| Fax | 9042680306 |
| Phone | +1 904-268-0904 |
Authorized person
| Name | DR. LARRY DAVID BURNSIDE |
| Role | PRESIDENT |
| Phone | 9042680904 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | 7825 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BURNSIDE, LARRY D. | Agent | 205 East Kari Court, Saint Johns, FL 32259 |
| Name | Role | Address |
|---|---|---|
| BURNSIDE, LARRY | President | 205 East Kari Court, St. Johns, FL 32259 |
| Name | Role | Address |
|---|---|---|
| BURNSIDE, DONNA E | Vice President | 205 East Kari Court, St. Johns, FL 32259 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-01-27 | 12708-3 SAN JOSE BLVD, JACKSONVILLE, FL 32223 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-26 | 205 East Kari Court, Saint Johns, FL 32259 | No data |
| REINSTATEMENT | 2011-04-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1999-06-01 | 12708-3 SAN JOSE BLVD, JACKSONVILLE, FL 32223 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-28 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-03-13 |
| ANNUAL REPORT | 2015-01-25 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
