| Entity Name: | MID BAY DENTAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MID BAY DENTAL, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 31 Dec 2014 (10 years ago) |
| Document Number: | L14000196989 |
| FEI/EIN Number |
NOT APPLICABLE
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4579 FLORIDA HWY 20 E, NICEVILLE, FL, 32578, US |
| Mail Address: | 4579 FLORIDA HWY 20 E, NICEVILLE, FL, 32578, US |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528427739 | 2016-02-16 | 2022-02-04 | 4579 E HIGHWAY 20 STE 210, NICEVILLE, FL, 325789810, US | 4579 E HIGHWAY 20 STE 210, NICEVILLE, FL, 325789810, US | |||||||||||||||||
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| Phone | +1 850-897-4200 |
Authorized person
| Name | FAITH GASKINS |
| Role | DIRECTOR OF CREDENTIALING |
| Phone | 9728693789 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN20656 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHASE JUSTINE | Manager | 4579 FLORIDA HWY 20 E, NICEVILLE, FL, 32578 |
| Chase Justine Dr. | Agent | 4579 FLORIDA HWY 20 E, NICEVILLE, FL, 32578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-09 | 4579 FLORIDA HWY 20 E, Suite 210, NICEVILLE, FL 32578 | - |
| CHANGE OF MAILING ADDRESS | 2020-02-09 | 4579 FLORIDA HWY 20 E, Suite 210, NICEVILLE, FL 32578 | - |
| REGISTERED AGENT NAME CHANGED | 2020-02-09 | Chase, Justine, Dr. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-09 | 4579 FLORIDA HWY 20 E, Suite 210, NICEVILLE, FL 32578 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-06 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-02-03 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-02-09 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-03-24 |
| ANNUAL REPORT | 2016-04-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2664667300 | 2020-04-29 | 0491 | PPP | 4579 HIGHWAY 20 E, SUITE 210, NICEVILLE, FL, 32578-9810 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6073008500 | 2021-03-02 | 0491 | PPS | 4579 E Highway 20 Ste 210, Niceville, FL, 32578-9810 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
