| Entity Name: | 1500 DENTAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
1500 DENTAL, LLC 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: | 01 Jun 2017 (8 years ago) |
| Document Number: | L17000120279 |
| FEI/EIN Number |
822445662
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1500 NORTH FEDERAL HWY., SUITE 250, FT. LAUDERDALE, FL, 33304, US |
| Mail Address: | 1500 NORTH FEDERAL HWY., SUITE 250, FT. LAUDERDALE, FL, 33304, US |
| ZIP code: | 33304 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073002259 | 2018-05-03 | 2018-05-03 | 1500 N FEDERAL HWY STE 250, FORT LAUDERDALE, FL, 333045603, US | 1500 N FEDERAL HWY STE 250, FORT LAUDERDALE, FL, 333045603, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-715-1000 |
| Fax | 9543721000 |
Authorized person
| Name | NEKELDA A WEISS |
| Role | INSURANCE & CREDENTIALING COORDINAT |
| Phone | 9547151000 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN14284 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1223P0300X - Periodontist |
| License Number | DN16336 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1407978679 |
| State | FL |
| Issuer | NPI |
| Number | 1043392111 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1500 DENTAL, LLC 401(K) PROFIT | 2020 | 822445662 | 2021-02-22 | 1500 DENTAL, LLC | 25 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2021-02-22 |
| Name of individual signing | KRISTEN DAVIS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-02-22 |
| Name of individual signing | KRISTEN DAVIS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 9547151000 |
| Plan sponsor’s address | 1500 NORTH FEDERAL HWY., SUITE 250, FORT LAUDERDALE, FL, 33304 |
Signature of
| Role | Plan administrator |
| Date | 2021-03-24 |
| Name of individual signing | KRISTEN DAVIS |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 9547151000 |
| Plan sponsor’s address | 1500 NORTH FEDERAL HWY., SUITE 250, FORT LAUDERDALE, FL, 33304 |
Signature of
| Role | Plan administrator |
| Date | 2021-02-22 |
| Name of individual signing | KRISTEN DAVIS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 9547151000 |
| Plan sponsor’s address | 1500 N FEDERAL HWY, FORT LAUDERDALE, FL, 33304 |
Plan administrator’s name and address
| Administrator’s EIN | 264477125 |
| Plan administrator’s name | 401K GENERATION |
| Plan administrator’s address | 195 INTERNATIONAL PKWY, S #311, LAKE MARY, FL, 32746 |
| Administrator’s telephone number | 8669985879 |
Signature of
| Role | Plan administrator |
| Date | 2019-04-18 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| 1500 DENTAL CORP. | Manager | 1500 NORTH FEDERAL HWY., SUITE 250, FT. LAUDERDALE, FL, 33304 |
| ORANGE PARK DENTAL PARTNERS, LLC | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-03-14 | ORANGE PARK DENTAL PARTNERS | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-14 | 2455 East Sunrise Blvd,, Suite 500, Fort Lauderdale, FL 33304 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-01-19 |
| ANNUAL REPORT | 2020-02-06 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-04-27 |
| Florida Limited Liability | 2017-06-01 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4671338506 | 2021-02-26 | 0455 | PPS | 1500 N Federal Hwy Ste 250, Fort Lauderdale, FL, 33304-5603 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
