| Entity Name: | LUCE TOOTH PEDIATRIC DENTISTRY PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 May 2019 (6 years ago) |
| Document Number: | L19000127530 |
| FEI/EIN Number | 84-1846634 |
| Address: | 8500 113th St, Seminole, FL, 33772, US |
| Mail Address: | 8500 113th St, Seminole, FL, 33772, US |
| ZIP code: | 33772 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548989569 | 2022-08-23 | 2022-08-23 | 4641 SHORT LEAF LN NE, SAINT PETERSBURG, FL, 337033147, US | 8500 113TH ST STE B, SEMINOLE, FL, 337724126, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 804-519-7795 |
| Phone | +1 727-390-0037 |
Authorized person
| Name | DR. AMY RENEE LUCE |
| Role | OWNER/DENTIST |
| Phone | 7276567145 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA BOARD OF DENTISTRY |
| Number | DN18737 |
| State | FL |
| Issuer | FLORIDA BOARD OF DENTISTRY |
| Number | DN21100 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LUCE TOOTH PEDIATRIC DENTISTRY, PLLC 401K | 2023 | 841846634 | 2024-10-08 | LUCE TOOTH PEDIATRIC DENTISTRY, PLLC | 2 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-10-08 |
| Name of individual signing | SCOTT AARON SCHEPS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| AMY LUCE PEDIATRIC DENTISTRY PLLC | Agent |
| Name | Role | Address |
|---|---|---|
| LUCE AMY R | Manager | 4641 SHORT LEAF LN NE, SAINT PETERSBURG, FL, 337033147 |
| Scheps Scott A | Manager | 4641 SHORT LEAF LN NE, SAINT PETERSBURG, FL, 337033147 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-01-04 | AMY LUCE PEDIATRIC DENTISTRY, PLLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-24 | 8500 113th St, Ste B, Seminole, FL 33772 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-24 | 8500 113th St, Ste B, Seminole, FL 33772 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-11 | 4641 SHORT LEAF LN NE, SAINT PETERSBURG, FL 33703 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-04 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-06-27 |
| Florida Limited Liability | 2019-05-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
