| Entity Name: | DENNIS R MOONEY DDS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Sep 2005 (19 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Sep 2010 (14 years ago) |
| Document Number: | L05000095702 |
| FEI/EIN Number | 203670936 |
| Address: | 215 OCHLOCKONEE STREET, CRAWFORDVILLE, FL, 32327, US |
| Mail Address: | 215 OCHLOCKONEE STREET, CRAWFORDVILLE, FL, 32327, US |
| ZIP code: | 32327 |
| County: | Wakulla |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710907191 | 2006-07-20 | 2012-09-10 | 215 OCHLOCKONEE ST, CRAWFORDVILLE, FL, 323278022, US | 215 OCHLOCKONEE ST, CRAWFORDVILLE, FL, 323278022, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-926-7151 |
| Fax | 8509266116 |
Authorized person
| Name | MRS. LEIGH E ANNAND |
| Role | OFFICE MANAGER |
| Phone | 8509267151 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN0006229 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 074033100 |
| State | FL |
| Issuer | PRO. # - ADI, INC. |
| Number | 42086 |
| Issuer | PRO. # - COMPBENEFITS COR |
| Number | 580933 |
| Issuer | PRO. # - MCNA |
| Number | 141 |
| State | FL |
| Issuer | PRO. # - METLIFE |
| Number | 65978 |
| Issuer | PRO. # - BCBS |
| Number | 85439 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOONEY DENNIS RDDS | Agent | 215 OCHLOCKONEE STREET, CRAWFORDVILLE, FL, 32327 |
| Name | Role | Address |
|---|---|---|
| MOONEY DENNIS RDDS | Manager | 215 OCHLOCKONEE STREET, CRAWFORDVILLE, FL, 32327 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-05-01 | MOONEY, DENNIS R., DDS | No data |
| REINSTATEMENT | 2010-09-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-31 | 215 OCHLOCKONEE STREET, CRAWFORDVILLE, FL 32327 | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-31 | 215 OCHLOCKONEE STREET, CRAWFORDVILLE, FL 32327 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-29 | 215 OCHLOCKONEE STREET, CRAWFORDVILLE, FL 32327 | No data |
| CANCEL ADM DISS/REV | 2007-10-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-18 |
| ANNUAL REPORT | 2019-05-03 |
| ANNUAL REPORT | 2018-08-28 |
| ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2016-07-07 |
| ANNUAL REPORT | 2015-04-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
