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  5. CRAIG C. LEWIS, D.D.S., P.A.

CRAIG C. LEWIS, D.D.S., P.A.

Company Details

Entity Name: CRAIG C. LEWIS, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 30 May 1984 (41 years ago)
Document Number: H05816
FEI/EIN Number 592433819
Address: 914 EMMETT STREET, KISSIMMEE, FL, 34741
Mail Address: 914 EMMETT STREET, KISSIMMEE, FL, 34741
ZIP code: 34741
County: Osceola
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1598882367 2007-03-25 2020-08-22 914 EMMETT ST, KISSIMMEE, FL, 347415436, US 914 EMMETT ST, KISSIMMEE, FL, 347415436, US

Contacts
Phone +1 407-846-2150

Authorized person
Name DR. CRFAIG C LEWIS
Role ORTHODONTIST
Phone 4078462150

Taxonomy
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number 6886
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CRAIG C. LEWIS, D.D.S., P.A. CASH BALANCE PLAN 2010 592433819 2011-07-06 CRAIG C. LEWIS, D.D.S., P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4073484032
Plan sponsor’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744

Plan administrator’s name and address
Administrator’s EIN 592433819
Plan administrator’s name CRAIG C. LEWIS, D.D.S., P.A.
Plan administrator’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744
Administrator’s telephone number 4073484032

Signature of
Role Plan administrator
Date 2011-07-06
Name of individual signing CRAIG C. LEWIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-06
Name of individual signing CRAIG C. LEWIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature
CRAIG C. LEWIS, D.D.S., P.A. CASH BALANCE PLAN 2010 592433819 2011-04-01 CRAIG C. LEWIS, D.D.S., P.A. 9
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4073484032
Plan sponsor’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744

Plan administrator’s name and address
Administrator’s EIN 592433819
Plan administrator’s name CRAIG C. LEWIS, D.D.S., P.A.
Plan administrator’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744
Administrator’s telephone number 4073484032

Signature of
Role Plan administrator
Date 2011-04-01
Name of individual signing CRAIG C. LEWIS, D.D.S.
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-04-01
Name of individual signing CRAIG C. LEWIS, D.D.S.
Valid signature Filed with incorrect/unrecognized electronic signature
CRAIG C. LEWIS, D.D.S., P.A. CASH BALANCE PLAN 2009 592433819 2010-08-20 CRAIG C. LEWIS, D.D.S., P.A. 9
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4073484032
Plan sponsor’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744

Plan administrator’s name and address
Administrator’s EIN 592433819
Plan administrator’s name CRAIG C. LEWIS, D.D.S., P.A.
Plan administrator’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744
Administrator’s telephone number 4073484032
CRAIG C. LEWIS, D.D.S., P.A. CASH BALANCE PLAN 2009 592433819 2010-08-20 CRAIG C. LEWIS, D.D.S., P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4073484032
Plan sponsor’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744

Plan administrator’s name and address
Administrator’s EIN 592433819
Plan administrator’s name CRAIG C. LEWIS, D.D.S., P.A.
Plan administrator’s address 1757 LEE JANZEN DRIVE, KISSIMMEE, FL, 34744
Administrator’s telephone number 4073484032

Signature of
Role Plan administrator
Date 2010-08-20
Name of individual signing CRAIG C. LEWIS D.D.S.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-20
Name of individual signing CRAIG C. LEWIS, D.D.S.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
LEWIS CRAIG C Agent 1757 LEE JANZEN DR., KISSIMMEE, FL, 34744

President

Name Role Address
LEWIS, CRAIG C. President 1757 LEE JANZEN DR, KISSIMMEE, FL, 34744

Director

Name Role Address
LEWIS, CRAIG C. Director 1757 LEE JANZEN DR., KISSIMMEE, FL, 34744
LEWIS, JO A Director 1757 LEE JANZEN DR., KISSIMMEE, FL, 34744

Secretary

Name Role Address
LEWIS, JO A Secretary 1757 LEE JANZEN DR., KISSIMMEE, FL, 34744

Treasurer

Name Role Address
LEWIS, JO A Treasurer 1757 LEE JANZEN DR., KISSIMMEE, FL, 34744

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2012-03-15 No data No data

Related by officers

LEWIS, JO A

TRANQUILITY PROPERTIES AND MANAGEMENT INC. 622 FX SERVICES INC LG FRANKLIN VENTURES, LLC

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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