| Entity Name: | SHASAN WILLIAM LIOU, DMD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Dec 2016 (8 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 14 Sep 2021 (3 years ago) |
| Document Number: | L16000225085 |
| FEI/EIN Number | 81-5119349 |
| Address: | 2970 Brandywine Road, Suite 200, Atlanta, GA, 30341, US |
| Mail Address: | 2970 Brandywine Road, Suite 200, Atlanta, GA, 30341, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730697723 | 2018-01-12 | 2018-01-12 | 10021 PINES BLVD STE 100, PEMBROKE PINES, FL, 330246191, US | 12331 SW 3RD ST STE 5, PLANTATION, FL, 333252813, US | |||||||||||||||||||||
|
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| Phone | +1 844-304-5437 |
Authorized person
| Name | DR. SHASAN WILLIAM LIOU |
| Role | MANAGER |
| Phone | 6784271412 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | DN19743 |
| State | FL |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Santiago Gerardo | Auth | 2970 Brandywine Road, Atlanta, GA, 30341 |
| Name | Role | Address |
|---|---|---|
| Santiago Gerardo | Member | 2970 Brandywine Road, Atlanta, GA, 30341 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000007546 | AMERICAN PEDIATRIC DENTAL GROUP | EXPIRED | 2018-01-15 | 2023-12-31 | No data | 10021 PINES BLVD., STE 100, PEMBROKE PINES, FL, 33024 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-20 | 2970 Brandywine Road, Suite 200, Atlanta, GA 30341 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-20 | 2970 Brandywine Road, Suite 200, Atlanta, GA 30341 | No data |
| LC STMNT OF RA/RO CHG | 2021-09-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-09-14 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-09-14 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000030488 | TERMINATED | 1000000907285 | BROWARD | 2022-01-14 | 2032-01-19 | $ 6,358.06 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-20 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-24 |
| CORLCRACHG | 2021-09-14 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-25 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-03-14 |
| ANNUAL REPORT | 2017-02-25 |
| Florida Limited Liability | 2016-12-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
