| Entity Name: | JUNIOR SMILES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Dec 2016 (8 years ago) |
| Document Number: | L16000227400 |
| FEI/EIN Number | 82-1353068 |
| Address: | 10071 Sunset Strip, Sunrise, FL 33322 |
| Mail Address: | 10071 Sunset Strip, Sunrise, FL 33322 |
| ZIP code: | 33322 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295398881 | 2019-04-18 | 2019-04-18 | 4183 NW 56TH ST, COCONUT CREEK, FL, 33073, US | 8223 W ATLANTIC BLVD, CORAL SPRINGS, FL, 33071, US | |||||||||||||||||||||||||
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| Phone | +1 860-515-8433 |
| Phone | +1 954-507-0015 |
Authorized person
| Name | TIFFANY A BRADY |
| Role | PRESIDENT/PEDIATRIC DENTIST |
| Phone | 8608395228 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | No |
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 01544500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BRADY, TIFFANY A | Agent | 10071 Sunset Strip, Sunrise, FL 33322 |
| Name | Role | Address |
|---|---|---|
| BRADY, TIFFANY A., Dr. | President | 10071 Sunset Strip, Sunrise, FL 33322 |
| Name | Role | Address |
|---|---|---|
| Jonassaint, Katiana A. | Manager | 10071 Sunset Strip, Sunrise, FL 33322 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-30 | 10071 Sunset Strip, Sunrise, FL 33322 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-30 | 10071 Sunset Strip, Sunrise, FL 33322 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-30 | 10071 Sunset Strip, Sunrise, FL 33322 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-03-30 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-07-05 |
| Florida Limited Liability | 2016-12-16 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5640838200 | 2020-08-08 | 0455 | PPP | 4183 NW 56TH ST, COCONUT CREEK, FL, 33073-4009 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 18 Feb 2025
Sources: Florida Department of State
