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  5. ORTEGA ORTHODONTICS, PLLC

ORTEGA ORTHODONTICS, PLLC

Company Details

Entity Name: ORTEGA ORTHODONTICS, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 28 Jan 2014 (11 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 31 Mar 2014 (11 years ago)
Document Number: L14000015294
FEI/EIN Number 46-5603476
Address: 5435 Ortega Blvd., Suite 2, JACKSONVILLE, FL 32210
Mail Address: 5435 Ortega Blvd., Suite 2, JACKSONVILLE, FL 32210
ZIP code: 32210
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1265845457 2014-06-05 2014-06-05 5435 ORTEGA BLVD, SUITE #2, JACKSONVILLE, FL, 322108435, US 5435 ORTEGA BLVD, SUITE #2, JACKSONVILLE, FL, 322108435, US

Contacts
Phone +1 904-388-4600
Fax 9043899499

Authorized person
Name DR. WILLIAM VAUGHN HOLLAND
Role OWNER
Phone 9043884600

Taxonomy
Taxonomy Code 261QD0000X - Dental Clinic/Center
License Number DN18644
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTEGA ORTHODONTICS, PLLC CASH BALANCE PLAN 2023 465603476 2024-09-12 ORTEGA ORTHODONTICS, PLLC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5435 ORTEGA BLVD., SUITE 2, JACKSONVILLE, FL, 32210
ORTEGA ORTHODONTICS, PLLC RETIREMENT SAVINGS PLAN 2023 465603476 2024-07-24 ORTEGA ORTHODONTICS, PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5435 ORTEGA BLVD. SUITE 2, JACKSONVILLE, FL, 32210
ORTEGA ORTHODONTICS, PLLC CASH BALANCE PLAN 2022 465603476 2023-11-28 ORTEGA ORTHODONTICS, PLLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210
ORTEGA ORTHODONTICS, PLLC RETIREMENT SAVINGS PLAN 2022 465603476 2023-07-24 ORTEGA ORTHODONTICS, PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210
ORTEGA ORTHODONTICS, PLLC RETIREMENT SAVINGS PLAN 2021 465603476 2023-01-28 ORTEGA ORTHODONTICS, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210
ORTEGA ORTHODONTICS, PLLC CASH BALANCE PLAN 2021 465603476 2022-12-14 ORTEGA ORTHODONTICS, PLLC 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210
ORTEGA ORTHODONTICS, PLLC RETIREMENT SAVINGS PLAN 2020 465603476 2021-09-10 ORTEGA ORTHODONTICS, PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210
ORTEGA ORTHODONTICS, PLLC RETIREMENT SAVINGS PLAN 2019 465603476 2020-10-01 ORTEGA ORTHODONTICS, PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210

Signature of
Role Plan administrator
Date 2020-10-01
Name of individual signing WILLIAM VAUGHN HOLLAND, DMD, MD
Valid signature Filed with authorized/valid electronic signature
ORTEGA ORTHODONTICS, PLLC RETIREMENT SAVINGS PLAN 2018 465603476 2019-10-15 ORTEGA ORTHODONTICS, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing WILLIAM VAUGHN HOLLAND, DMD, MD
Valid signature Filed with authorized/valid electronic signature
ORTEGA ORTHODONTICS, PLLC RETIREMENT SAVINGS PLAN 2017 465603476 2018-07-12 ORTEGA ORTHODONTICS, PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043884600
Plan sponsor’s address 5090 ORTEGA FOREST DRIVE, JACKSONVILLE, FL, 32210

Signature of
Role Plan administrator
Date 2018-07-12
Name of individual signing WILLIAM VAUGHN HOLLAND, DMD, MD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
HOLLAND, WILLIAM VAUGHN Agent 5435 Ortega Blvd., Suite 2, JACKSONVILLE, FL 32210

Director

Name Role Address
Holland, Vaughn Director 5435 Ortega Blvd., Suite 2 JACKSONVILLE, FL 32210

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2020-09-10 5435 Ortega Blvd., Suite 2, JACKSONVILLE, FL 32210 No data
CHANGE OF MAILING ADDRESS 2020-09-10 5435 Ortega Blvd., Suite 2, JACKSONVILLE, FL 32210 No data
REGISTERED AGENT ADDRESS CHANGED 2020-09-10 5435 Ortega Blvd., Suite 2, JACKSONVILLE, FL 32210 No data
LC STMNT OF RA/RO CHG 2014-03-31 No data No data

Documents

Name Date
ANNUAL REPORT 2024-03-04
ANNUAL REPORT 2023-02-21
ANNUAL REPORT 2022-02-18
ANNUAL REPORT 2021-02-15
AMENDED ANNUAL REPORT 2020-09-10
ANNUAL REPORT 2020-02-15
ANNUAL REPORT 2019-02-27
ANNUAL REPORT 2018-02-21
ANNUAL REPORT 2017-02-11
ANNUAL REPORT 2016-04-07

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6138797106 2020-04-14 0491 PPP 5435 ORTEGA BLVD #2, JACKSONVILLE, FL, 32210-8435
Loan Status Date 2021-02-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 82077
Loan Approval Amount (current) 82077
Undisbursed Amount 0
Franchise Name -
Lender Location ID 123987
Servicing Lender Name Cogent Bank
Servicing Lender Address 420 S Orange Ave, Ste 150, ORLANDO, FL, 32801
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address JACKSONVILLE, DUVAL, FL, 32210-8435
Project Congressional District FL-04
Number of Employees 8
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 123987
Originating Lender Name Cogent Bank
Originating Lender Address ORLANDO, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 82672.06
Forgiveness Paid Date 2021-01-08

Related by officers

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Date of last update: 21 Feb 2025

Sources: Florida Department of State

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