Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Leon
    4. ›
  4. 32312
    5. ›
  5. TALLAHASSEE ENDODONTICS, LLC

TALLAHASSEE ENDODONTICS, LLC

Company Details

Entity Name: TALLAHASSEE ENDODONTICS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 06 Nov 2003 (21 years ago)
Last Event: LC NAME CHANGE
Event Date Filed: 30 Sep 2011 (13 years ago)
Document Number: L03000044039
FEI/EIN Number 562413445
Address: 1348 Timberlane Road, TALLAHASSEE, FL, 32312, US
Mail Address: 1348 Timberlane Road, TALLAHASSEE, FL, 32312, US
ZIP code: 32312
County: Leon
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1851938153 2019-12-05 2019-12-05 1348 TIMBERLANE RD, TALLAHASSEE, FL, 323121766, US 1348 TIMBERLANE RD, TALLAHASSEE, FL, 323121766, US

Contacts
Phone +1 850-878-5131

Authorized person
Name DYLAN TIDWELL
Role OFFICE MANAGER
Phone 8508785131

Taxonomy
Taxonomy Code 1223E0200X - Endodontist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2023 562413445 2024-07-15 TALLAHASSEE ENDODONTICS, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2022 562413445 2023-07-13 TALLAHASSEE ENDODONTICS, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2021 562413445 2022-10-01 TALLAHASSEE ENDODONTICS, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2020 562413445 2021-07-22 TALLAHASSEE ENDODONTICS, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2019 562413445 2020-08-06 TALLAHASSEE ENDODONTICS, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2018 562413445 2019-08-19 TALLAHASSEE ENDODONTICS, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2017 562413445 2018-09-17 TALLAHASSEE ENDODONTICS, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2016 562413445 2017-10-09 TALLAHASSEE ENDODONTICS, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2015 562413445 2016-09-28 TALLAHASSEE ENDODONTICS, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312

Signature of
Role Plan administrator
Date 2016-09-28
Name of individual signing TERESA FAULKENBERRY
Valid signature Filed with authorized/valid electronic signature
TALLAHASSEE ENDODONTICS, LLC 401(K) PROFIT SHARING PLAN 2014 562413445 2015-09-23 TALLAHASSEE ENDODONTICS, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8508785131
Plan sponsor’s address 1913 CAPITAL CIRCLE, NE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2015-09-23
Name of individual signing TERESA FAULKENBERRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SIMON PHILLIP Agent 1348 Timberlane Road, TALLAHASSEE, FL, 32312

Manager

Name Role Address
Simon Phillip Manager 1348 Timberlane Road, TALLAHASSEE, FL, 32312

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G11000089332 TALLAHASSEE ENDODONTICS ACTIVE 2011-09-09 2026-12-31 No data 1348 TIMBERLANE ROAD, TALLAHASSEE, FL, 32312

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2016-03-25 1348 Timberlane Road, TALLAHASSEE, FL 32312 No data
CHANGE OF MAILING ADDRESS 2016-03-25 1348 Timberlane Road, TALLAHASSEE, FL 32312 No data
REGISTERED AGENT NAME CHANGED 2016-03-25 SIMON, PHILLIP No data
REGISTERED AGENT ADDRESS CHANGED 2016-03-25 1348 Timberlane Road, TALLAHASSEE, FL 32312 No data
LC NAME CHANGE 2011-09-30 TALLAHASSEE ENDODONTICS, LLC No data

Documents

Name Date
ANNUAL REPORT 2025-01-21
ANNUAL REPORT 2024-02-12
ANNUAL REPORT 2023-02-18
ANNUAL REPORT 2022-01-28
ANNUAL REPORT 2021-02-09
ANNUAL REPORT 2020-02-01
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-01-06
ANNUAL REPORT 2017-01-16
ANNUAL REPORT 2016-03-25

Related by officers

SIMON PHILLIP

TALL STONE ASSET MANAGEMENT, LLC MIPS PROPERTIES OF NORTH FLORIDA, LLC SIMON WORKS LLC ALL PHASE CONSULTING, INC. TELECOM COMMUNICATIONS CORP.

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated