| Entity Name: | BEACHSIDE ORAL SURGERY AND IMPLANTS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 06 May 2015 (10 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L15000080013 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 257 East Eaugllie Blvd, Indian Harbour Beach, FL, 32937, US |
| Mail Address: | 257 East Eaugllie Blvd, Indian Harbour Beach, FL, 32937, US |
| ZIP code: | 32937 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164801825 | 2015-05-27 | 2015-05-27 | 205 E EAUGALLE BLVD, 257, INDIAN HARBOURE BEACH, FL, 32937, US | 205 E EAU GALLIE BLVD, 257, INDIAN HARBOUR BEACH, FL, 329374873, US | |||||||||||||||||
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| Phone | +1 321-473-8247 |
Authorized person
| Name | MRS. JAYANTHI CHOPRA |
| Role | EMPLOYEE |
| Phone | 3214738247 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| License Number | 18935 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BEACHSIDE ORAL SURGERY AND IMPLANTS 401K PLAN | 2022 | 473920219 | 2023-07-16 | BEACHSIDE ORAL SURGERY AND IMPLANTS | 6 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-07-16 |
| Name of individual signing | JAYANTHI CHOPRA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3214267816 |
| Plan sponsor’s address | 257 EAST EAUGALLIE BLVD, INDIAN HARBOUR BEACH, FL, 32937 |
Signature of
| Role | Plan administrator |
| Date | 2022-06-24 |
| Name of individual signing | JAYANTHI CHOPRA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3214267816 |
| Plan sponsor’s address | 257 EAST EAUGALLIE BLVD, INDIAN HARBOUR BEACH, FL, 32937 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-26 |
| Name of individual signing | PUTHALI GANNE |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-07-26 |
| Name of individual signing | JAYANTHI CHOPRA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3214267816 |
| Plan sponsor’s address | 257 EAST EAUGALLIE BLVD, INDIAN HARBOUR BEACH, FL, 32937 |
Signature of
| Role | Plan administrator |
| Date | 2019-05-08 |
| Name of individual signing | JAYANTHI CHOPRA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2019-05-08 |
| Name of individual signing | JAYANTHI CHOPRA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3214267816 |
| Plan sponsor’s address | 257 EAST EAUGALLIE BLVD, INDIAN HARBOUR BEACH, FL, 32937 |
Signature of
| Role | Plan administrator |
| Date | 2018-05-25 |
| Name of individual signing | JAYANTHI CHOPRA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CHOPRA JAYANTHI | Agent | 257 East Eaugllie Blvd, Indian Harbour Beach, FL, 32937 |
| Name | Role | Address |
|---|---|---|
| CHOPRA JAYANTHI | Manager | 257 East Eaugllie Blvd, Indian Harbour Beach, FL, 32937 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-10 | 257 East Eaugllie Blvd, Indian Harbour Beach, FL 32937 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-10 | 257 East Eaugllie Blvd, Indian Harbour Beach, FL 32937 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-10 | CHOPRA, JAYANTHI | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-10 | 257 East Eaugllie Blvd, Indian Harbour Beach, FL 32937 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-01-10 |
| ANNUAL REPORT | 2021-01-08 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-03-08 |
| Florida Limited Liability | 2015-05-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
