| Entity Name: | JASON E. BAKER D.D.S. LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Dec 2006 (18 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 20 Sep 2018 (6 years ago) |
| Document Number: | L06000120762 |
| FEI/EIN Number | 274480107 |
| Address: | 77 SOUTH SHORE DRIVE, MIRAMAR BEACH, FL, 32550, US |
| Mail Address: | 16220 NORTH SCOTTSDALE ROAD, SCOTTSDALE, AZ, 85254, US |
| ZIP code: | 32550 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093051344 | 2012-12-13 | 2015-06-30 | 77 S SHORE DR, MIRAMAR BEACH, FL, 325504967, US | 77 SOUTH SHORE DRIVE, MIRAMAR BEACH, FL, 32550, US | |||||||||||||||||||
|
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| Phone | +1 850-650-2070 |
| Fax | 8506502073 |
Authorized person
| Name | DANIELLE S DAUGHERTY |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 8506502070 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 17784 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| BAKER JASON E | Owne | 77 SOUTH SHORE DRIVE, MIRAMAR BEACH, FL, 32550 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000130814 | MIRAMAR BEACH DENTAL & ORTHODONTICS | ACTIVE | 2023-10-24 | 2028-12-31 | No data | 77 SOUTH SHORE DRIVE, MIRAMAR BEACH, FL, 32550 |
| G15000013027 | MIRAMAR BEACH DENTAL & ORTHODONTICS | EXPIRED | 2015-02-05 | 2020-12-31 | No data | 10221 US HWY 98 W, SUITE 10, MIRAMAR BEACH, FL, 32550 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-27 | 77 SOUTH SHORE DRIVE, MIRAMAR BEACH, FL 32550 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-27 | 77 SOUTH SHORE DRIVE, MIRAMAR BEACH, FL 32550 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-03-27 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-27 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| LC AMENDMENT | 2018-09-20 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-26 |
| ANNUAL REPORT | 2024-03-27 |
| AMENDED ANNUAL REPORT | 2023-08-11 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-04-15 |
| LC Amendment | 2018-09-20 |
| ANNUAL REPORT | 2018-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
