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  5. ORLANDO ORAL & FACIAL SURGERY, PLLC

ORLANDO ORAL & FACIAL SURGERY, PLLC

Company Details

Entity Name: ORLANDO ORAL & FACIAL SURGERY, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 13 Aug 2012 (12 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 20 Nov 2013 (11 years ago)
Document Number: L12000105829
FEI/EIN Number 46-0796483
Address: 2045 LEE ROAD, WINTER PARK, FL, 32789
Mail Address: 2045 LEE ROAD, WINTER PARK, FL, 32789
ZIP code: 32789
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205920204 2006-10-03 2016-06-02 2045 LEE RD, WINTER PARK, FL, 327891836, US 2045 LEE RD, WINTER PARK, FL, 327891836, US

Contacts
Phone +1 407-629-4444
Fax 4076299078

Authorized person
Name MRS. EVELIS GERENA
Role ACCOUNTS PAYABLE
Phone 4076294444

Taxonomy
Taxonomy Code 1223P0106X - Oral and Maxillofacial Pathology Dentist
Is Primary No
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
Is Primary Yes
Taxonomy Code 1223X0008X - Oral and Maxillofacial Radiology Dentist
Is Primary No
Taxonomy Code 174400000X - Specialist
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2021 460796483 2023-03-13 ORLANDO ORAL & FACIAL SURGERY, PLLC 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2023-03-09
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-03-09
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2020 460796483 2021-10-14 ORLANDO ORAL & FACIAL SURGERY, PLLC 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-14
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2019 460796483 2020-09-13 ORLANDO ORAL & FACIAL SURGERY, PLLC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2020-08-24
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-24
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2018 460796483 2019-10-11 ORLANDO ORAL & FACIAL SURGERY, PLLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2019-10-11
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-11
Name of individual signing EVELIS GERENA
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2017 460796483 2018-02-16 ORLANDO ORAL & FACIAL SURGERY, PLLC 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2018-02-06
Name of individual signing DEAN WHITMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-02-06
Name of individual signing DEAN WHITMAN
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2016 460796483 2017-07-27 ORLANDO ORAL & FACIAL SURGERY, PLLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-27
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2015 460796483 2016-07-29 ORLANDO ORAL & FACIAL SURGERY, PLLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-29
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2014 460796483 2015-07-23 ORLANDO ORAL & FACIAL SURGERY, PLLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-23
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2013 460796483 2014-06-10 ORLANDO ORAL & FACIAL SURGERY, PLLC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2014-06-05
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-05
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
ORLANDO ORAL & FACIAL SURGERY, PLLC 401(K) PLAN 2012 460796483 2013-04-23 ORLANDO ORAL & FACIAL SURGERY, PLLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-19
Business code 621111
Sponsor’s telephone number 4076294444
Plan sponsor’s address 2045 LEE ROAD, WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2013-04-16
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-16
Name of individual signing DEAN H. WHITMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Gerena Evelis Agent 2045 LEE ROAD, WINTER PARK, FL, 32789

Manager

Name Role Address
Dean H. Whitman, DMD, PA Manager 2045 LEE ROAD, WINTER PARK, FL, 32789
Martinez Oral & Facial Surgery, PA Manager 2045 LEE ROAD, WINTER PARK, FL, 32789
Goldberg Oral and Facial Surgery, PA Manager 2045 LEE ROAD, WINTER PARK, FL, 32789

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2014-04-24 Gerena, Evelis No data
LC AMENDMENT 2013-11-20 No data No data
LC AMENDMENT 2013-05-23 No data No data

Documents

Name Date
ANNUAL REPORT 2024-04-22
ANNUAL REPORT 2023-04-11
ANNUAL REPORT 2022-04-08
ANNUAL REPORT 2021-04-23
ANNUAL REPORT 2020-06-09
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-04-20
ANNUAL REPORT 2017-02-13
ANNUAL REPORT 2016-04-21
AMENDED ANNUAL REPORT 2015-09-10

Related by officers

Gerena Evelis

MARTINEZ ORAL & FACIAL SURGERY, P.A.

Related by address

2045 LEE ROAD, WINTER PARK, FL, 32789

DEAN H. WHITMAN,DMD, P.A. OCOEE PROPERTY GROUP, LLC

2045 LEE ROAD, WINTER PARK, FL, 32789

DEAN H. WHITMAN,DMD, P.A. OCOEE PROPERTY GROUP, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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