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  5. DDSDMD LLC

DDSDMD LLC

Company Details

Entity Name: DDSDMD LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 22 Jul 2008 (17 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 14 Nov 2008 (16 years ago)
Document Number: L08000070194
FEI/EIN Number 263209956
Address: 1433 Piedmont Drive East, Tallahassee, FL, 32308, US
Mail Address: 1433 Piedmont Drive East, Tallahassee, FL, 32308, US
ZIP code: 32308
County: Leon
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1700145349 2012-05-15 2012-05-15 5716 FARNSWORTH DR, TALLAHASSEE, FL, 323124881, US 2621 MITCHAM DR, SUITE #102, TALLAHASSEE, FL, 323085480, US

Contacts
Phone +1 850-566-2972
Fax 8502191527
Phone +1 850-425-1300

Authorized person
Name DR. RICHARD JEAN-PIERRE BASTIEN
Role OWNER
Phone 8505662972

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number DN17786
State FL
Is Primary Yes

Other Provider Identifiers
Issuer NPPES
Number 1619274529
State FL
Issuer NPPES
Number 1770782039
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2023 263209956 2024-05-20 DDSDMD, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 1433 PIEDMONT DRIVE EAST, SUITE 200, TALLAHASSEE, FL, 32308
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2022 263209956 2023-03-17 DDSDMD, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 1433 PIEDMONT DRIVE EAST, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2023-03-17
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2021 263209956 2022-06-15 DDSDMD, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 1433 PIEDMONT DRIVE EAST, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2022-06-15
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2020 263209956 2021-08-05 DDSDMD, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 1433 PIEDMONT EAST DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2021-08-05
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2019 263209956 2020-10-13 DDSDMD, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 1433 PIEDMONT EAST DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2020-10-13
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2018 263209956 2019-10-11 DDSDMD, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 2621 MITCHAM DRIVE, SUITE 102, TALLAHASSEE, FL, 323085481

Signature of
Role Plan administrator
Date 2019-10-11
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-11
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2017 263209956 2018-10-08 DDSDMD, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 2621 MITCHAM DRIVE, SUITE 102, TALLAHASSEE, FL, 323085481

Signature of
Role Plan administrator
Date 2018-10-08
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-08
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2016 263209956 2017-10-13 DDSDMD, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 2621 MITCHAM DRIVE, SUITE 102, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-13
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2015 263209956 2016-10-04 DDSDMD, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 2621 MITCHAM DRIVE, SUITE 102, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2016-10-04
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-04
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
DDSDMD, LLC 401(K) PROFIT SHARING PLAN 2014 263209956 2015-10-07 DDSDMD, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621112
Sponsor’s telephone number 8504251300
Plan sponsor’s address 2621 MITCHAM DRIVE, SUITE 102, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2015-10-06
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-06
Name of individual signing RICHARD BASTIEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
KING & WOOD, P.A. Agent

Manager

Name Role Address
BASTIEN RICHARD JDR. Manager 1433 PIEDMONT DRIVE EAST, TALLAHASSEE, FL, 32308

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000033784 BASTIEN DENTAL CARE ACTIVE 2021-03-10 2026-12-31 No data 6599 LAKE PISGAH DR., TALLAHASSEE, FL, 32309
G17000006363 BASTIEN DENTAL CARE EXPIRED 2017-01-18 2022-12-31 No data 5699 LAKE PISGAH DR., TALLAHASSEE, FL, 32309
G16000024605 BASTIEN DENTAL CARE EXPIRED 2016-03-08 2021-12-31 No data 6599 LAKE PISGAH DR, TALLAHASSEE, FL, 32309
G10000095889 BASTIEN DENTAL CARE EXPIRED 2010-10-19 2015-12-31 No data 2533 CARTHAGE LANE, TALLAHASSEE, FL, 32312
G10000040039 TALLAHASSEE DENTAL CARE EXPIRED 2010-05-05 2015-12-31 No data 2533 CARTHAGE LANE, TALLAHASSEE, FL, 32312

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-10-05 1433 Piedmont Drive East, Tallahassee, FL 32308 No data
CHANGE OF PRINCIPAL ADDRESS 2023-09-11 1433 Piedmont Drive East, Tallahassee, FL 32308 No data
REGISTERED AGENT NAME CHANGED 2021-03-30 KING & WOOD, P.A. No data
REGISTERED AGENT ADDRESS CHANGED 2021-03-30 1701 HERMITAGE BLVD STE 203, TALLAHASSEE, FL 32308 No data
LC AMENDMENT 2008-11-14 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-10
ANNUAL REPORT 2024-02-12
ANNUAL REPORT 2023-01-03
ANNUAL REPORT 2022-03-04
ANNUAL REPORT 2021-03-30
ANNUAL REPORT 2020-01-11
ANNUAL REPORT 2019-03-22
ANNUAL REPORT 2018-03-07
AMENDED ANNUAL REPORT 2017-06-22
ANNUAL REPORT 2017-01-18

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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