| Entity Name: | PEDO ORTHO DENTAL SPECIALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PEDO ORTHO DENTAL SPECIALISTS, 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 02 Oct 2017 (8 years ago) |
| Date of dissolution: | 24 Jun 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 24 Jun 2018 (7 years ago) |
| Document Number: | L17000203356 |
| Address: | 8950 S.W. 74TH COURT, SUITE 1214, MIAMI, FL, 33156, US |
| Mail Address: | 8950 S.W. 74TH COURT, SUITE 1214, MIAMI, FL, 33156, US |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538673975 | 2017-11-21 | 2017-11-21 | 8950 SW 74TH CT STE 124, MIAMI, FL, 331563171, US | 8950 SW 74TH CT STE 124, MIAMI, FL, 331563171, US | |||||||||||||||||||||||||||||
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| Phone | +1 954-268-9825 |
Authorized person
| Name | STEPHEN CRISCUOLO |
| Role | DMD/OWNER |
| Phone | 9542689825 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | DN21814 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008662900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 019273100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRUSSMARK STEPHEN | Authorized Member | 8950 S.W. 74TH COURT SUITE 1214, MIAMI, FL, 33156 |
| FISHMAN LEWIS W | Agent | 7700 NORTH KENDALL DRIVE, MIAMI, FL, 33156 |
| IDENTAL SYSTEMS LLC | Authorized Member | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-06-24 | - | - |
| Name | Date |
|---|---|
| Florida Limited Liability | 2017-10-02 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
