| Entity Name: | JONESVILLE DENTISTRY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Feb 2019 (6 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 08 Jun 2020 (5 years ago) |
| Document Number: | L19000047705 |
| FEI/EIN Number | 84-2307892 |
| Address: | 13576 NW 2nd Lane, SUITE 30, Newberry, FL, 32669, US |
| Mail Address: | 13576 NW 2nd Lane, SUITE 30, Newberry, FL, 32669, US |
| ZIP code: | 32669 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548889926 | 2020-04-15 | 2020-04-15 | 13576 NW 2ND LN STE 30, NEWBERRY, FL, 326693736, US | 13576 NW 2ND LN STE 30, NEWBERRY, FL, 326693736, US | |||||||||||||||||||||||||
|
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| Phone | +1 352-354-3601 |
Authorized person
| Name | DR. SEAN THERON WILLIAMS |
| Role | OWNER |
| Phone | 8505177640 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI - INDIVIDUAL |
| Number | 1306376512 |
| State | FL |
| Issuer | FLORIDA BOARD OF DENTISTRY |
| Number | DN22573 |
| State | FL |
| Name | Role |
|---|---|
| WARNER, SECHREST & BUTTS, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| WILLIAMS SEAN T | Manager | 13576 NW 2nd Lane, Newberry, FL, 32669 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000100754 | RADIANT DENTISTRY | EXPIRED | 2019-09-13 | 2024-12-31 | No data | 13576 NW 2ND LANE STE 30, NEWBERRY, FL, 32669 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2020-06-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-06-08 | WARNER, SECHREST & BUTTS, P.A. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-08 | 5200 SW 91ST TERRACE, STE 101, GAINESVILLE, FL 32608 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-15 | 13576 NW 2nd Lane, SUITE 30, Newberry, FL 32669 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-15 | 13576 NW 2nd Lane, SUITE 30, Newberry, FL 32669 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-03-07 |
| ANNUAL REPORT | 2021-01-13 |
| CORLCRACHG | 2020-06-08 |
| ANNUAL REPORT | 2020-05-15 |
| Florida Limited Liability | 2019-02-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
