| Entity Name: | COSMETIC & FAMILY DENTISTRY, PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Sep 2003 (21 years ago) |
| Document Number: | L03000033655 |
| FEI/EIN Number | 421603385 |
| Mail Address: | 8147 WHISTLEWING COURT, ORLANDO, FL, 32817 |
| Address: | 6900 TURKEY LAKE ROAD, STE 1-9, ORLANDO, FL, 32819 |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245783422 | 2016-07-25 | 2016-07-25 | 6900 TURKEY LAKE RD, # 1-9, ORLANDO, FL, 328194707, US | 6900 TURKEY LAKE RD, # 1-9, ORLANDO, FL, 328194707, US | |||||||||||||||||||||||||
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| Phone | +1 407-352-7700 |
| Fax | 4073527787 |
Authorized person
| Name | RAVI C OBEROI |
| Role | OWNER |
| Phone | 4073527700 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN14640 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 07599450 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OBEROI RAVI | Agent | 8147 WHISTLEWING COURT, ORLANDO, FL, 32817 |
| Name | Role | Address |
|---|---|---|
| OBEROI RAVI | Managing Member | 8147 WHISTLEWING COURT, ORLANDO, FL, 32817 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2010-02-28 | 6900 TURKEY LAKE ROAD, STE 1-9, ORLANDO, FL 32819 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-04-26 |
| AMENDED ANNUAL REPORT | 2021-12-01 |
| ANNUAL REPORT | 2021-01-09 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-01-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
