| Entity Name: | RAJIV TULADHAR DMD HOLDINGS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Jul 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 11 Jan 2017 (8 years ago) |
| Document Number: | L15000121501 |
| FEI/EIN Number | 474594781 |
| Address: | 516 MARY ESTHER BLVD, FT. WALTON BEACH, FL, 32548, US |
| Mail Address: | 516 MARY ESTHER BLVD, FT. WALTON BEACH, FL, 32548, US |
| ZIP code: | 32548 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265808455 | 2015-08-11 | 2015-08-11 | 516 MARY ESTHER BLVD, STE 2, FORT WALTON BEACH, FL, 32548, US | 516 MARY ESTHER BLVD STE 2, FORT WALTON BEACH, FL, 32548, US | |||||||||||||||||||
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| Phone | +1 850-659-3119 |
| Fax | 8502430245 |
Authorized person
| Name | KIM VAN CAMP |
| Role | PROVIDER RELATIONS SPECIALIST |
| Phone | 3154546000 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN20980 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NASON, YEAGER, GERSON, HARRIS & FUMERO, P. | Agent | 3001 PGA BOULEVARD, PALM BEACH GARDENS, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| TULADHAR RAJIV DMD | Manager | 516 MARY ESTHER BLVD, FT. WALTON BEACH, FL, 32548 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000126478 | ASPEN DENTAL | ACTIVE | 2021-09-22 | 2026-12-31 | No data | 516 MARY ESTHER BLVD, STE 2, FORT WALTON BEACH, FL, 32548 |
| G16000006763 | ASPEN DENTAL | EXPIRED | 2016-01-19 | 2021-12-31 | No data | 516 MARY ESTHER BLVD SUITE 2, FORT WALTON BEACH, FL, 32548 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-07-07 | 3001 PGA BOULEVARD, SUITE 305, PALM BEACH GARDENS, FL 33410 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-02-21 | 516 MARY ESTHER BLVD, SUITE 2, FT. WALTON BEACH, FL 32548 | No data |
| CHANGE OF MAILING ADDRESS | 2018-02-21 | 516 MARY ESTHER BLVD, SUITE 2, FT. WALTON BEACH, FL 32548 | No data |
| REINSTATEMENT | 2017-01-11 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-11 | NASON, YEAGER, GERSON, HARRIS & FUMERO, P.A | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-03-28 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-02-21 |
| REINSTATEMENT | 2017-01-11 |
| Florida Limited Liability | 2015-07-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
