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CLERMONT PEDIATRIC DENTISTRY, PLLC - Florida Company Profile

Company Details

Entity Name: CLERMONT PEDIATRIC DENTISTRY, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

CLERMONT PEDIATRIC DENTISTRY, PLLC 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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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: 05 Oct 2018 (6 years ago)
Document Number: L18000258397
FEI/EIN Number 83-2515313

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 3165 CITRUS TOWER BLVD., CLERMONT,, FL, 34711
Mail Address: 3165 CITRUS TOWER BLVD., CLERMONT,, FL, 34711
ZIP code: 34711
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1598234015 2018-11-14 2018-11-14 3165 CITRUS TOWER BLVD, CLERMONT, FL, 347116883, US 3165 CITRUS TOWER BLVD, CLERMONT, FL, 347116883, US

Contacts

Phone +1 352-241-6333

Authorized person

Name DR. JULIE M RUSSO
Role PARTNER
Phone 3522416333

Taxonomy

Taxonomy Code 1223P0221X - Pediatric Dentist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLERMONT PEDIATRIC DENTISTRY RETIREMENT PLAN & TRUST 2023 832515313 2024-06-03 CLERMONT PEDIATRIC DENTISTRY, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
LISA M. STOKES, D.D.S. M.S., P.A., DEFINED BENEFIT CASH BALANCE PLAN 2022 832515313 2023-08-02 CLERMONT PEDIATRIC DENTISTRY, PLLC 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
CLERMONT PEDIATRIC DENTISTRY DEFINED BENEFIT CASH BALANCE PLAN & TRUST 2022 832515313 2023-05-30 CLERMONT PEDIATRIC DENTISTRY, PLLC 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
CLERMONT PEDIATRIC DENTISTRY RETIREMENT PLAN & TRUST 2022 832515313 2023-06-13 CLERMONT PEDIATRIC DENTISTRY, PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
CLERMONT PEDIATRIC DENTISTRY RETIREMENT PLAN & TRUST 2021 832515313 2022-08-31 CLERMONT PEDIATRIC DENTISTRY, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
CLERMONT PEDIATRIC DENTISTRY RETIREMENT PLAN & TRUST 2020 832515313 2021-09-10 CLERMONT PEDIATRIC DENTISTRY, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
CLERMONT PEDIATRIC DENTISTRY RETIREMENT PLAN & TRUST 2019 832515313 2020-07-06 CLERMONT PEDIATRIC DENTISTRY, PLLC 14
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
CLERMONT PEDIATRIC DENTISTRY RETIREMENT PLAN & TRUST 2019 832515313 2021-01-25 CLERMONT PEDIATRIC DENTISTRY, PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 3522416333
Plan sponsor’s address 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711

Key Officers & Management

Name Role Address
JULIE M. RUSSO D.M.D., P.A. Authorized Member -
RUSSO JULIE M Agent 3165 CITRUS TOWER BLVD., CLERMONT, FL, 34711
ALEXANDRA D. JENSEN, D.M.D., P.A. Authorized Member -

Documents

Name Date
ANNUAL REPORT 2024-02-09
ANNUAL REPORT 2023-02-06
ANNUAL REPORT 2022-02-28
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-02-05
AMENDED ANNUAL REPORT 2019-04-04
ANNUAL REPORT 2019-04-02
Florida Limited Liability 2018-10-05

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4630448508 2021-02-26 0491 PPS 3165 Citrus Tower Blvd, Clermont, FL, 34711-6883
Loan Status Date 2021-12-18
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 128014
Loan Approval Amount (current) 128014
Undisbursed Amount 0
Franchise Name -
Lender Location ID 342931
Servicing Lender Name Mainstreet Community Bank of Florida
Servicing Lender Address 204 S Woodland Blvd, DE LAND, FL, 32720-5414
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Clermont, LAKE, FL, 34711-6883
Project Congressional District FL-11
Number of Employees 18
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 342931
Originating Lender Name Mainstreet Community Bank of Florida
Originating Lender Address DE LAND, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 128959.88
Forgiveness Paid Date 2021-11-24

Date of last update: 02 Mar 2025

Sources: Florida Department of State