| Entity Name: | OLDSMAR DENTAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
OLDSMAR 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: | 27 Jan 2016 (9 years ago) |
| Document Number: | L16000016457 |
| FEI/EIN Number |
81-1376799
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4050 TAMPA ROAD, OLDSMAR, FL, 34677, US |
| Mail Address: | 5810 SCHOONER WAY, TAMPA, FL, 33615, US |
| ZIP code: | 34677 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245772078 | 2016-11-10 | 2016-11-10 | 4050 TAMPA RD, OLDSMAR, FL, 346773205, US | 4050 TAMPA RD, OLDSMAR, FL, 346773205, US | |||||||||||||||||||||||||||
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| Phone | +1 813-855-4269 |
| Fax | 8138554277 |
Authorized person
| Name | DR. LORI ELIZABETH BURCHELL |
| Role | DOCTOR/OWNER |
| Phone | 8138554269 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN18371 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN8894 |
| State | FL |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OLDSMAR DENTAL, PLLC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 811376799 | 2024-06-07 | OLDSMAR DENTAL, PLLC | 9 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-06-07 |
| Name of individual signing | DANA DAVIDSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8137679503 |
| Plan sponsor’s address | 4050 TAMPA ROAD, OLDSMAR, FL, 34677 |
Signature of
| Role | Plan administrator |
| Date | 2024-02-26 |
| Name of individual signing | DANA DAVIDSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8137679503 |
| Plan sponsor’s address | 4050 TAMPA RD., OLDSMAR, FL, 34677 |
Signature of
| Role | Plan administrator |
| Date | 2022-05-04 |
| Name of individual signing | LORI BURCHELL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8137679503 |
| Plan sponsor’s address | 4050 TAMPA RD., OLDSMAR, FL, 34677 |
Signature of
| Role | Plan administrator |
| Date | 2021-06-22 |
| Name of individual signing | LORI BURCHELL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8137679503 |
| Plan sponsor’s address | 4050 TAMPA RD., OLDSMAR, FL, 34677 |
Signature of
| Role | Plan administrator |
| Date | 2020-05-12 |
| Name of individual signing | LORI BURCHELL |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BURCHELL LORI D.M.D. | Manager | 5810 SCHOONER WAY, TAMPA, FL, 33615 |
| MAGIDSON MICHAEL D | Agent | 333 THIRD AVENUE NORTH, SUITE 200, ST PETERSBURG, FL, 33701 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000018489 | OLDSMAR DENTISTRY | ACTIVE | 2016-02-19 | 2026-12-31 | - | 4050 TAMPA ROAD, OLDSMAR, FL, 34677 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-09 |
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-01-11 |
| ANNUAL REPORT | 2018-04-12 |
| ANNUAL REPORT | 2017-02-08 |
| Florida Limited Liability | 2016-01-27 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5773348602 | 2021-03-20 | 0455 | PPS | 4050 Tampa Rd, Oldsmar, FL, 34677-3205 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6369237709 | 2020-05-01 | 0455 | PPP | 4050 TAMPA RD, OLDSMAR, FL, 34677-3205 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
