| Entity Name: | CHACE DENTAL, PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jun 2006 (19 years ago) |
| Document Number: | L06000060028 |
| FEI/EIN Number | 205025337 |
| Address: | 4479 N. Harbor City Blvd, MELBOURNE, FL, 32935, US |
| Mail Address: | 4479 N. Harbor City Blvd, MELBOURNE, FL, 32935, US |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952529596 | 2007-04-20 | 2015-05-21 | 4479 N HARBOR CITY BLVD, MELBOURNE, FL, 329354800, US | 4479 N HARBOR CITY BLVD, MELBOURNE, FL, 329354800, US | |||||||||||||||
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| Phone | +1 321-242-3300 |
| Fax | 3212429393 |
Authorized person
| Name | DR. JENNIFER B CHACE |
| Role | DENTIST |
| Phone | 3212423300 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHACE DENTAL PL 401 K PROFIT SHARING PLAN TRUST | 2010 | 205025337 | 2011-07-27 | CHACE DENTAL PL | 8 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 205025337 |
| Plan administrator’s name | CHACE DENTAL PL |
| Plan administrator’s address | 3200 N WICKHAM RD, STE 5, MELBOURNE, FL, 329350000 |
| Administrator’s telephone number | 3212423300 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-27 |
| Name of individual signing | CHACE DENTAL PL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3212423300 |
| Plan sponsor’s address | 3200 N WICKHAM RD, STE 5, MELBOURNE, FL, 329350000 |
Plan administrator’s name and address
| Administrator’s EIN | 205025337 |
| Plan administrator’s name | CHACE DENTAL PL |
| Plan administrator’s address | 3200 N WICKHAM RD, STE 5, MELBOURNE, FL, 329350000 |
| Administrator’s telephone number | 3212423300 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-23 |
| Name of individual signing | CHACE DENTAL PL |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3212423300 |
| Plan sponsor’s address | 3200 N WICKHAM RD, STE 5, MELBOURNE, FL, 329350000 |
Plan administrator’s name and address
| Administrator’s EIN | 205025337 |
| Plan administrator’s name | CHACE DENTAL PL |
| Plan administrator’s address | 3200 N WICKHAM RD, STE 5, MELBOURNE, FL, 329350000 |
| Administrator’s telephone number | 3212423300 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-22 |
| Name of individual signing | CHACE DENTAL PL |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| Name | Role | Address |
|---|---|---|
| CHACE JENNIFER BDMD | Agent | 4479 N. Harbor City Blvd, MELBOURNE, FL, 32935 |
| Name | Role | Address |
|---|---|---|
| CHACE JENNIFER BDr. | DMD | 4479 N. Harbor City Blvd, MELBOURNE, FL, 32935 |
| CHACE Gregory RDr. | DMD | 4479 N. Harbor City Blvd, MELBOURNE, FL, 32935 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G25000007447 | CHACE WELLNESS | ACTIVE | 2025-01-16 | 2030-12-31 | No data | 4479 NORTH HARBOR CITY BOULEVARD, MELBOURNE, FL, 32935 |
| G24000074301 | GENTLE DENTAL ASSOCIATES | ACTIVE | 2024-06-17 | 2029-12-31 | No data | 4479 N HARBOR CITY BLVD, MELBOURNE, FL, 32935 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2018-02-14 | CHACE, JENNIFER B, DMD | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-01-22 | 4479 N. Harbor City Blvd, MELBOURNE, FL 32935 | No data |
| CHANGE OF MAILING ADDRESS | 2016-01-22 | 4479 N. Harbor City Blvd, MELBOURNE, FL 32935 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-22 | 4479 N. Harbor City Blvd, MELBOURNE, FL 32935 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-02-14 |
| ANNUAL REPORT | 2017-02-13 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
