| Entity Name: | MARYAM BANGASH DDS HOLDINGS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MARYAM BANGASH DDS HOLDINGS, 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 24 Jul 2015 (10 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | L15000125893 |
| FEI/EIN Number |
474687758
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1291 Peregrine Way, Weston, FL, 33327, US |
| Mail Address: | 1291 Peregrine Way, Weston, FL, 33327, US |
| ZIP code: | 33327 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255707774 | 2015-08-19 | 2015-08-19 | 24185 US HIGHWAY 27, LAKE WALES, FL, 338597819, US | 24185 US HIGHWAY 27, LAKE WALES, FL, 338597819, US | |||||||||||||||||||
|
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| Phone | +1 863-676-6200 |
| Fax | 8636792561 |
Authorized person
| Name | KIM VAN CAMP |
| Role | PROVIDER RELATIONS SPECIALIST |
| Phone | 3154546000 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN20272 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BANGASH MARYAM DDS | Manager | 1291 Peregrine Way, Weston, FL, 33327 |
| DFS AGENT, LLC | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000058957 | ASPEN DENTAL | EXPIRED | 2018-05-15 | 2023-12-31 | - | 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-21 | 1291 Peregrine Way, Weston, FL 33327 | - |
| CHANGE OF MAILING ADDRESS | 2022-04-21 | 1291 Peregrine Way, Weston, FL 33327 | - |
| REGISTERED AGENT NAME CHANGED | 2018-04-25 | DFS Agent LLC | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-12 | 1760 N Jog Rd Ste 150, West Palm Beach, FL 33411 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-02-06 |
| ANNUAL REPORT | 2020-01-25 |
| ANNUAL REPORT | 2019-03-06 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-02-15 |
| ANNUAL REPORT | 2016-03-12 |
| Florida Limited Liability | 2015-07-24 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
