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IMPLANT DENTISTRY OF VENICE, LLC - Florida Company Profile

Company Details

Entity Name: IMPLANT DENTISTRY OF VENICE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

IMPLANT DENTISTRY OF VENICE, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 02 Dec 2002 (22 years ago)
Date of dissolution: 27 Sep 2019 (5 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2019 (5 years ago)
Document Number: L02000032388
FEI/EIN Number 571141668

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1515 SOUTH TAMIAMI TRAIL, STE. 3, VENICE, FL, 34285, US
Mail Address: 1515 SOUTH TAMIAMI TRAIL, STE. 3, VENICE, FL, 34285, US
ZIP code: 34285
County: Sarasota
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871681692 2006-10-10 2020-08-22 1515 TAMIAMI TRAIL S, SUITE 3, VENICE, FL, 34285, US 1515 TAMIAMI TRAIL S, SUITE 3, VENICE, FL, 34285, US

Contacts

Phone +1 941-497-1585
Fax 9414967905

Authorized person

Name DR. DAVID M CHAMPION
Role PRESIDENT
Phone 9414971585

Taxonomy

Taxonomy Code 122300000X - Dentist
License Number 6743
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN 2013 571141668 2014-10-06 IMPLANT DENTISTRY OF VENICE, LLC 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 9414971585
Plan sponsor’s mailing address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
Plan sponsor’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285

Number of participants as of the end of the plan year

Active participants 7
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN 2012 571141668 2013-10-11 IMPLANT DENTISTRY OF VENICE, LLC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 9414971585
Plan sponsor’s mailing address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
Plan sponsor’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285

Number of participants as of the end of the plan year

Active participants 7
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of

Role Plan administrator
Date 2013-10-11
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-11
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN 2011 571141668 2012-10-12 IMPLANT DENTISTRY OF VENICE, LLC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 9414971585
Plan sponsor’s mailing address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
Plan sponsor’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285

Plan administrator’s name and address

Administrator’s EIN 571141668
Plan administrator’s name IMPLANT DENTISTRY OF VENICE, LLC
Plan administrator’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
Administrator’s telephone number 9414971585

Number of participants as of the end of the plan year

Active participants 8
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2012-10-12
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-12
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN 2010 571141668 2011-10-03 IMPLANT DENTISTRY OF VENICE, LLC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 9414971585
Plan sponsor’s mailing address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
Plan sponsor’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285

Plan administrator’s name and address

Administrator’s EIN 571141668
Plan administrator’s name IMPLANT DENTISTRY OF VENICE, LLC
Plan administrator’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
Administrator’s telephone number 9414971585

Number of participants as of the end of the plan year

Active participants 6
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of

Role Plan administrator
Date 2011-10-03
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-03
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature
IMPLANT DENTISTRY OF VENICE, LLC DEFINED BENEFIT PENSION PLAN AND TRUST 2009 571141668 2010-10-12 IMPLANT DENTISTRY OF VENICE, LLC 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 9414971585
Plan sponsor’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285

Plan administrator’s name and address

Administrator’s EIN 571141668
Plan administrator’s name IMPLANT DENTISTRY OF VENICE, LLC
Plan administrator’s address 1515 S. TAMIAMI TRAIL, SUITE 3, VENICE, FL, 34285
Administrator’s telephone number 9414971585

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing DAVID M. CHAMPION
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
WILLIAMS JOSEPHINE Manager 19328 PUMMELO DR, ORLANDO, FL, 32827
REEGLER SARI LYNN Agent 1521 SOUTH TAMIAMI TRAIL, STE. 304, VENICE, FL, 34285

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 - -
LC AMENDMENT 2019-07-24 - -
REINSTATEMENT 2007-10-09 - -
CHANGE OF PRINCIPAL ADDRESS 2007-10-09 1515 SOUTH TAMIAMI TRAIL, STE. 3, VENICE, FL 34285 -
CHANGE OF MAILING ADDRESS 2007-10-09 1515 SOUTH TAMIAMI TRAIL, STE. 3, VENICE, FL 34285 -
REGISTERED AGENT ADDRESS CHANGED 2007-10-09 1521 SOUTH TAMIAMI TRAIL, STE. 304, VENICE, FL 34285 -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2007-09-14 - -

Documents

Name Date
LC Amendment 2019-07-24
ANNUAL REPORT 2018-03-07
ANNUAL REPORT 2017-05-24
ANNUAL REPORT 2016-02-11
ANNUAL REPORT 2015-01-28
ANNUAL REPORT 2014-04-21
ANNUAL REPORT 2013-04-16
ANNUAL REPORT 2012-09-18
ANNUAL REPORT 2011-04-25
ANNUAL REPORT 2010-04-01

Date of last update: 03 Mar 2025

Sources: Florida Department of State