| Entity Name: | STEVENS DENTAL PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Dec 2018 (6 years ago) |
| Document Number: | L18000277726 |
| FEI/EIN Number | 83-2732656 |
| Address: | 840 US- 1, NORTH PALM BEACH, FL, 33408, US |
| Mail Address: | 840 US- 1, NORTH PALM BEACH, FL, 33408, US |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730748765 | 2019-06-12 | 2019-06-12 | 2700 PGA BLVD STE 202, PALM BEACH GARDENS, FL, 334102958, US | 2700 PGA BLVD STE 202, PALM BEACH GARDENS, FL, 334102958, US | |||||||||||||||
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| Phone | +1 561-622-6100 |
| Fax | 5616226107 |
Authorized person
| Name | DR. ERIC STEVENS |
| Role | OWNER |
| Phone | 2392387633 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVENS DENTAL PLLC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 832732656 | 2024-05-22 | STEVENS DENTAL PLLC | 1 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-05-22 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2392387633 |
| Plan sponsor’s address | 2700 PGA BLVD - STE 202B, WEST PALM BEACH, FL, 33410 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-05 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Stevens Eric DDr. | Agent | 840 US- 1, NORTH PALM BEACH, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| STEVENS ERIC D | Authorized Member | 840 US- 1, NORTH PALM BEACH, FL, 33408 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000085809 | CUSTOM DENTISTRY | ACTIVE | 2020-07-21 | 2025-12-31 | No data | 840 US HIGHWAY 1, STE 205, NORTH PALM BEACH, FL, 33408 |
| G19000073677 | CUSTOM DENTISTRY PBG | EXPIRED | 2019-07-04 | 2024-12-31 | No data | 2700 PGA BOULEVARD, SUITE 202B, PALM BEACH GARDENS, FL, 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-08 | 840 US- 1, SUITE 205, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-06-23 | 840 US- 1, SUITE 205, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF MAILING ADDRESS | 2022-06-23 | 840 US- 1, SUITE 205, NORTH PALM BEACH, FL 33408 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-26 | Stevens, Eric Daniel, Dr. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| ANNUAL REPORT | 2023-03-08 |
| AMENDED ANNUAL REPORT | 2022-09-08 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-05-10 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-30 |
| Florida Limited Liability | 2018-12-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
