| Entity Name: | BLUE SKY DENTAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Aug 2014 (10 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 29 Feb 2016 (9 years ago) |
| Document Number: | L14000132577 |
| FEI/EIN Number | 47-3585279 |
| Address: | 14866 OLD ST AUGUSTINE RD, JACKSONVILLE, FL, 32258, US |
| Mail Address: | 14866 OLD ST AUGUSTINE RD, JACKSONVILLE, FL, 32258, US |
| ZIP code: | 32258 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720436157 | 2016-05-26 | 2016-05-26 | 14866 OLD ST. AUGUSTINE RD, SUITE 111 AND 112, JACKSONVILLE, FL, 32288, US | 14866 OLD ST. AUGUSTINE RD, SUITE 111 AND 112, JACKSONVILLE, FL, 32288, US | |||||||||||||||||
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| Phone | +1 904-229-5794 |
Authorized person
| Name | JONAS ASHBAUGH |
| Role | CEO |
| Phone | 9042295794 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN21709 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLUE SKY DENTAL GROUP, EQRP 401(K) PLAN | 2023 | 473585279 | 2024-02-06 | BLUE SKY DENTAL GROUP | 13 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-02-06 |
| Name of individual signing | JONAS ASHBAUGH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 9043426222 |
| Plan sponsor’s address | 14866 OLD ST. AUGUSTINE RD, SUITE 111, JACKSONVILLE, FL, 32258 |
Signature of
| Role | Plan administrator |
| Date | 2024-12-04 |
| Name of individual signing | JONAS ASHBAUGH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 9043426222 |
| Plan sponsor’s address | 14866 OLD ST. AUGUSTINE RD, SUITE 111, JACKSONVILLE, FL, 32258 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-04 |
| Name of individual signing | JONAS ASHBAUGH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 9043426222 |
| Plan sponsor’s address | 14866 OLD ST. AUGUSTINE RD, SUITE 111, JACKSONVILLE, FL, 32258 |
Signature of
| Role | Plan administrator |
| Date | 2022-08-25 |
| Name of individual signing | JONAS ASHBAUGH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 9043426222 |
| Plan sponsor’s address | 14866 OLD ST. AUGUSTINE RD, SUITE 111, JACKSONVILLE, FL, 32258 |
Signature of
| Role | Plan administrator |
| Date | 2021-09-17 |
| Name of individual signing | JONAS ASHBAUGH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ASHBAUGH JONAS J | Agent | 14866 OLD ST AUGUSTINE RD, JACKSONVILLE, FL, 32258 |
| Name | Role | Address |
|---|---|---|
| Ashbaugh Jonas J | Chief Executive Officer | 14866 OLD ST AUGUSTINE RD, JACKSONVILLE, FL, 32258 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000077217 | TRUE FINANCING | EXPIRED | 2018-07-16 | 2023-12-31 | No data | 14888 OLD ST. AUGUSTINE RD, STE 111, SUITE 111, JACKSONVILLE, FL, 32258 |
| G16000020052 | BLUE SKY DENTAL GROUP | ACTIVE | 2016-02-24 | 2026-12-31 | No data | 14866 OLD ST AUGUSTINE RD, SUITE 111, JACKSONVILLE, FL, 32258 |
| G15000033004 | BLUE SKY FAMILY DENTAL | EXPIRED | 2015-03-31 | 2020-12-31 | No data | 86058 MEADOWWOD DR, YULEE, FL, 32097 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-17 | 14866 OLD ST AUGUSTINE RD, 111, JACKSONVILLE, FL 32258 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-17 | 14866 OLD ST AUGUSTINE RD, 111, JACKSONVILLE, FL 32258 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-17 | 14866 OLD ST AUGUSTINE RD, 111, JACKSONVILLE, FL 32258 | No data |
| LC AMENDMENT AND NAME CHANGE | 2016-02-29 | BLUE SKY DENTAL GROUP LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-02-03 |
| ANNUAL REPORT | 2019-01-11 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-25 |
| ANNUAL REPORT | 2016-03-26 |
| LC Amendment and Name Change | 2016-02-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
