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  5. AMELIA DENTAL GROUP, PLLC

AMELIA DENTAL GROUP, PLLC - Florida Company Profile

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Company Details

Entity Name: AMELIA DENTAL GROUP, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 15 Oct 2015 (10 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 23 Jan 2024 (2 years ago)
Document Number: L15000175409
FEI/EIN Number 47-5341164
Address: 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US
Mail Address: 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US
ZIP code: 32034
City: Fernandina Beach
County: Nassau
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BIETENHOLZ JOSHUA ODMD Manager 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034
Blazejewski Justin EDMD Manager 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034
GARRETT STEVEN ADMD Manager 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034
MOKRIS JENNIFER LDMD Manager 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034
Mokris Jennifer LDMD Agent 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034

National Provider Identifier

NPI Number:
1649350349
Link:
View on NPI website

Authorized Person:

Name:
DR. LAURIE KITSON
Role:
SEC
Phone:
9042617181

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
No
Selected Taxonomy:
122300000X - Dentist
Is Primary:
No
Selected Taxonomy:
122300000X - Dentist
Is Primary:
No
Selected Taxonomy:
122300000X - Dentist
Is Primary:
No
Selected Taxonomy:
1223E0200X - Endodontist
Is Primary:
No

Contacts:

Phone:
+1 904-261-7181
Fax:
9042619797

Form 5500 Series

Employer Identification Number (EIN):
475341164
Plan Year:
2022
Number Of Participants:
45
Sponsors Telephone Number:
9042617181
File:
View File
Plan Year:
2021
Number Of Participants:
44
Sponsors Telephone Number:
9042617181
File:
View File
Plan Year:
2020
Number Of Participants:
42
Sponsors Telephone Number:
9042617181
File:
View File
Plan Year:
2019
Number Of Participants:
38
Sponsors Telephone Number:
9042617181
File:
View File
Plan Year:
2018
Number Of Participants:
39
Sponsors Telephone Number:
9042617181
File:
View File

Events

Event Type Filed Date Value Description
LC AMENDMENT 2024-01-23 - -
CHANGE OF PRINCIPAL ADDRESS 2024-01-22 1947 CITRONA DR, FERNANDINA BEACH, FL 32034 -
CHANGE OF MAILING ADDRESS 2024-01-22 1947 CITRONA DR, FERNANDINA BEACH, FL 32034 -
REGISTERED AGENT NAME CHANGED 2024-01-22 Mokris, Jennifer L, DMD -
REGISTERED AGENT ADDRESS CHANGED 2024-01-22 1947 CITRONA DR, FERNANDINA BEACH, FL 32034 -
LC AMENDMENT 2019-10-28 - -

Documents

Name Date
LC Amendment 2024-01-23
ANNUAL REPORT 2024-01-22
ANNUAL REPORT 2023-03-14
ANNUAL REPORT 2022-02-18
ANNUAL REPORT 2021-02-12
ANNUAL REPORT 2020-02-21
LC Amendment 2019-10-28
ANNUAL REPORT 2019-03-13
ANNUAL REPORT 2018-02-16
ANNUAL REPORT 2017-01-27

USAspending Awards / Financial Assistance

Date:
2020-04-27
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
290200.00
Total Face Value Of Loan:
290200.00
Date:
2020-04-27
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
290200.00
Total Face Value Of Loan:
290200.00
Date:
2020-04-19
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-19
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Paycheck Protection Program

Jobs Reported:
27
Initial Approval Amount:
$290,200
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$290,200
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Unanswered
Forgiveness Amount:
$291,958.98
Servicing Lender:
First Federal Bank
Use of Proceeds:
Payroll: $290,200

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Related by address

1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US

JUSTIN E. BLAZEJEWSKI, P.L.L.C.
Florida Limited Liability Co.
JUSTIN E. BLAZEJEWSKI, P.L.L.C., which currently Active, has registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.
JUSTIN E. BLAZEJEWSKI, P.L.L.C.
Florida Limited Liability Co.
JUSTIN E. BLAZEJEWSKI, P.L.L.C., which currently Active, has registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.
STEVEN A. GARRETT, DMD, PLLC
Florida Limited Liability Co.
STEVEN A. GARRETT, DMD, PLLC, which currently Active, has registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.
OWENS, VAN ETTA, KITSON AND BIETENHOLZ, P.A.
Domestic Profit
OWENS, VAN ETTA, KITSON AND BIETENHOLZ, P.A., which currently Inactive, had registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.

1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US

JUSTIN E. BLAZEJEWSKI, P.L.L.C.
Florida Limited Liability Co.
JUSTIN E. BLAZEJEWSKI, P.L.L.C., which currently Active, has registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.
JUSTIN E. BLAZEJEWSKI, P.L.L.C.
Florida Limited Liability Co.
JUSTIN E. BLAZEJEWSKI, P.L.L.C., which currently Active, has registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.
STEVEN A. GARRETT, DMD, PLLC
Florida Limited Liability Co.
STEVEN A. GARRETT, DMD, PLLC, which currently Active, has registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.
OWENS, VAN ETTA, KITSON AND BIETENHOLZ, P.A.
Domestic Profit
OWENS, VAN ETTA, KITSON AND BIETENHOLZ, P.A., which currently Inactive, had registered address 1947 CITRONA DR, FERNANDINA BEACH, FL, 32034, US.

Date of last update: 03 Aug 2025

Sources: Florida Department of State

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