| Entity Name: | J. KIM PERIODONTICS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 May 2004 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 15 Oct 2015 (9 years ago) |
| Document Number: | L04000034360 |
| FEI/EIN Number | 352230551 |
| Address: | 4570 CLYDE MORRIS BLVD., STE. 1, PORT ORANGE, FL, 32129, US |
| Mail Address: | 4570 CLYDE MORRIS BLVD., STE. 1, PORT ORANGE, FL, 32129, US |
| ZIP code: | 32129 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629198551 | 2007-04-02 | 2007-09-28 | 4570 S CLYDE MORRIS BLVD, SUITE 1, PORT ORANGE, FL, 321295401, US | 4570 S CLYDE MORRIS BLVD, SUITE 1, PORT ORANGE, FL, 321295401, US | |||||||||||||||||
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| Phone | +1 386-322-4867 |
Authorized person
| Name | DR. JEFFREY M KIM |
| Role | OWNER |
| Phone | 3863224867 |
Taxonomy
| Taxonomy Code | 1223P0300X - Periodontist |
| License Number | DN13917 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Kim Jeffrey MDr. | Agent | 4570 CLYDE MORRIS BLVD., PORT ORANGE, FL, 32129 |
| Name | Role | Address |
|---|---|---|
| KIM JEFFREY M | Managing Member | 4570 CLYDE MORRIS BLVD., PORT ORANGE, FL, 32129 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000067081 | JEFF KIM DENTAL | ACTIVE | 2024-05-27 | 2029-12-31 | No data | 4570 CLYDE MORRIS BLVD STE 1, PORT ORANGE, FL, 32129 |
| G09000112762 | ULLTIMATE DENTAL STUDIO | EXPIRED | 2009-06-02 | 2014-12-31 | No data | 4570 SOUTH CLYDE MORRIS BLVD., PORT ORANGE, FL, 32129 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-11 | 4570 CLYDE MORRIS BLVD., STE. 1, PORT ORANGE, FL 32129 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-11 | 4570 CLYDE MORRIS BLVD., STE. 1, PORT ORANGE, FL 32129 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-11 | 4570 CLYDE MORRIS BLVD., STE. 1, PORT ORANGE, FL 32129 | No data |
| REINSTATEMENT | 2015-10-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-10-15 | Kim, Jeffrey Mark, Dr. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-03-11 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-27 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5684457101 | 2020-04-13 | 0491 | PPP | 4570 Clyde Morris Blvd Ste 1, PORT ORANGE, FL, 32129-5402 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
