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  5. AMMAR MOUSA DDS, LLC

AMMAR MOUSA DDS, LLC

Company Details

Entity Name: AMMAR MOUSA DDS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 27 Dec 2010 (14 years ago)
Document Number: L10000131812
FEI/EIN Number 274484180
Address: 5427 Tildens Grove Blvd, Windermere, FL, 34786, US
Mail Address: 5427 Tildens Grove Blvd, Windermere, FL, 34786, US
ZIP code: 34786
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1265000822 2021-06-11 2021-06-11 590 S MAIN ST, WILDWOOD, FL, 347854832, US 590 S MAIN ST, WILDWOOD, FL, 347854832, US

Contacts
Phone +1 352-748-1880
Fax 3527483345

Authorized person
Name AMMAR MOUSA
Role DENTIST
Phone 3527481880

Taxonomy
Taxonomy Code 261QD0000X - Dental Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMMAR MOUSA DDS LLC 401K PLAN 2023 274484180 2024-06-24 AMMAR MOUSA DDS LLC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 3526362135
Plan sponsor’s address 5427 TILDENS GROVE BLVD, WINDERMERE, FL, 34786

Signature of
Role Plan administrator
Date 2024-06-24
Name of individual signing AMMAR MOUSA
Valid signature Filed with authorized/valid electronic signature
AMMAR MOUSA DDS LLC 401K PLAN 2022 274484180 2023-06-09 AMMAR MOUSA DDS LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 3526362135
Plan sponsor’s address 5427 TILDENS GROVE BLVD, WINDERMERE, FL, 34786

Signature of
Role Plan administrator
Date 2023-06-09
Name of individual signing AMMAR MOUSA
Valid signature Filed with authorized/valid electronic signature
AMMAR MOUSA DDS LLC 401K PLAN 2021 274484180 2022-07-13 AMMAR MOUSA DDS LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 3526362135
Plan sponsor’s address 5427 TILDENS GROVE BLVD, WINDERMERE, FL, 34786

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing AMMAR MOUSA
Valid signature Filed with authorized/valid electronic signature
AMMAR MOUSA DDS LLC 401K PLAN 2020 274484180 2021-09-01 AMMAR MOUSA DDS LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 3526362135
Plan sponsor’s address 5427 TILDENS GROVE BLVD, WINDERMERE, FL, 34786

Signature of
Role Plan administrator
Date 2021-09-01
Name of individual signing AMMAR MOUSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-01
Name of individual signing AMMAR MOUSA
Valid signature Filed with authorized/valid electronic signature
AMMAR MOUSA DDS LLC 401K PLAN 2019 274484180 2020-07-16 AMMAR MOUSA DDS LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 3526362135
Plan sponsor’s address 5427 TILDENS GROVE BLVD, WINDERMERE, FL, 34786

Signature of
Role Plan administrator
Date 2020-07-16
Name of individual signing AMMAR MOUSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-16
Name of individual signing AMMAR MOUSA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MEGAN GARCIA L Agent 9100 CONROY WINDERMERE ROAD, WINDERMERE, FL, 34786

Managing Member

Name Role Address
MOUSA AMMAR Managing Member 5427 Tildens Grove Blvd, Windermere, FL, 34786
MAHROUS NISREEN Managing Member 5427 Tildens Grove Blvd, Windermere, FL, 34786

REGI

Name Role Address
GARCIA MEGAN L REGI 9100 CONROY WINDERMERE ROAD, WINDERMERE, FL, 34786

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000024318 VILLAGES SMILES ACTIVE 2021-02-19 2026-12-31 No data 5427 TILDENS GROVE BLVD, WINDERMERE, FL, 34785
G17000011750 LAKE DEATON DENTAL EXPIRED 2017-01-31 2022-12-31 No data 717 KRISTINE WAY, THEY VILLAGES, FL, 32163
G16000036130 WILDWOOD DENTIST EXPIRED 2016-04-08 2021-12-31 No data 5427 TILDENS GROVE BLVD., WINDERMERE, FL, 34786
G11000007173 WILDWOOD DENTAL CARE EXPIRED 2011-01-17 2016-12-31 No data 590 SOUTH MAIN STREET, WILDWOOD, FL, 34785

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-02-28 MEGAN, GARCIA LOUISE No data
REGISTERED AGENT ADDRESS CHANGED 2024-02-28 9100 CONROY WINDERMERE ROAD, SUITE 200, WINDERMERE, FL 34786 No data
CHANGE OF PRINCIPAL ADDRESS 2016-01-23 5427 Tildens Grove Blvd, Windermere, FL 34786 No data
CHANGE OF MAILING ADDRESS 2016-01-23 5427 Tildens Grove Blvd, Windermere, FL 34786 No data

Documents

Name Date
ANNUAL REPORT 2024-02-28
ANNUAL REPORT 2023-04-27
ANNUAL REPORT 2022-04-09
ANNUAL REPORT 2021-03-14
ANNUAL REPORT 2020-03-15
ANNUAL REPORT 2019-04-20
ANNUAL REPORT 2018-04-01
ANNUAL REPORT 2017-02-13
ANNUAL REPORT 2016-01-23
ANNUAL REPORT 2015-01-12

Related by officers

MOUSA AMMAR

EZ DENTASCAN, INC MOUSSA LIMITED LIABILITY COMPANY WILDWOOD DENTAL ART LIMITED LIABILITY COMPANY CREATIVE DENTAL LLC A & A BROTHERS, LLC LEESBURG SMILES LLC ADZ ESTATES LLC ORLANDO BUSINESS GROUP CORPORATION MOUSA HOLDINGS, INC. BLOUDAN HOLDING LLC

MAHROUS NISREEN

MOUSSA LIMITED LIABILITY COMPANY ALEENA $ DALIYA LIMITED LIABILITY COMPANY BLOUDAN HOLDING LLC MAHROUS MANAGEMENT GROUP LLC

GARCIA MEGAN L

A & A BROTHERS, LLC CH MUNDO LLC BLOUDAN HOLDING LLC DAMAS VEST LLC BLOUDAN HOLDING, LLC WA LINDO LLLP ISLA DEL SOL VILLAS LLC RECOVA, LLC NABOO LLC

MEGAN GARCIA L

LEESBURG SMILES LLC

Related by address

5427 Tildens Grove Blvd, Windermere, FL, 34786, US

WILDWOOD DENTAL ART LIMITED LIABILITY COMPANY

5427 Tildens Grove Blvd, Windermere, FL, 34786, US

WILDWOOD DENTAL ART LIMITED LIABILITY COMPANY

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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