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  5. TOMOKA ORTHODONTICS LLC

TOMOKA ORTHODONTICS LLC

Company Details

Entity Name: TOMOKA ORTHODONTICS LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 18 Dec 2017 (7 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 11 Jan 2019 (6 years ago)
Document Number: L17000256876
FEI/EIN Number 82-3809975
Address: 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174, UN
Mail Address: 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174
ZIP code: 32174
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1821853201 2024-02-15 2024-02-15 163 TOMOKA AVE, ORMOND BEACH, FL, 321746348, US 163 TOMOKA AVE, ORMOND BEACH, FL, 321746348, US

Contacts
Phone +1 386-672-4325

Authorized person
Name DR. AMY E ANDREWS
Role MANAGER
Phone 3212666639

Taxonomy
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TOMOKA ORTHODONTICS, LLC CASH BALANCE PENSION PLAN 2023 823809975 2024-08-05 TOMOKA ORTHODONTICS, LLC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2024-08-05
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC 401(K) PROFIT SHARING PLAN 2023 823809975 2024-09-17 TOMOKA ORTHODONTICS, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s DBA name PA
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2024-09-17
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC CASH BALANCE PENSION PLAN 2022 823809975 2023-08-15 TOMOKA ORTHODONTICS, LLC 8
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2023-08-15
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC 401(K) PROFIT SHARING PLAN 2022 823809975 2023-09-01 TOMOKA ORTHODONTICS, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s DBA name PA
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2023-09-01
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC CASH BALANCE PENSION PLAN 2022 823809975 2024-07-25 TOMOKA ORTHODONTICS, LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2024-07-25
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC 401(K) PROFIT SHARING PLAN 2021 823809975 2022-10-12 TOMOKA ORTHODONTICS, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s DBA name PA
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2022-10-12
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC CASH BALANCE PENSION PLAN 2021 823809975 2022-07-13 TOMOKA ORTHODONTICS, LLC 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC 401(K) PROFIT SHARING PLAN 2020 823809975 2021-10-05 TOMOKA ORTHODONTICS, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s DBA name PA
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC CASH BALANCE PENSION PLAN 2020 823809975 2021-10-04 TOMOKA ORTHODONTICS, LLC 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2021-10-04
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature
TOMOKA ORTHODONTICS, LLC 401(K) PROFIT SHARING PLAN 2019 823809975 2020-10-09 TOMOKA ORTHODONTICS, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 3866724325
Plan sponsor’s DBA name PA
Plan sponsor’s address 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2020-10-09
Name of individual signing ELIZABETH MOREJON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Amy E. Andrews DMD, MDS PA Agent 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Manager

Name Role Address
AMY E ANDREWS DMD MDS PA Manager 163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G18000070349 MOREJON + ANDREWS ORTHODONTICS ACTIVE 2018-06-21 2028-12-31 No data 163 TOMOKA AVE, ORMOND BEACH, FL, 32174

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-02-06 Amy E. Andrews DMD, MDS PA No data
REINSTATEMENT 2019-01-11 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 No data No data

Documents

Name Date
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-01-30
ANNUAL REPORT 2022-02-15
ANNUAL REPORT 2021-02-16
ANNUAL REPORT 2020-06-08
REINSTATEMENT 2019-01-11
Florida Limited Liability 2017-12-18

Related by officers

No related officers

Related by address

163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174, UN

ELIZABETH A. MOREJON, D.M.D., M.S., P.A.

163 TOMOKA AVENUE, ORMOND BEACH, FL, 32174

AMY E. ANDREWS D.M.D., M.D.S., P.A. ELIZABETH A. MOREJON, D.M.D., M.S., P.A. TOMOKA PROPERTIES, LLC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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