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JACKSONVILLE DENTISTRY, PLLC - Florida Company Profile

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Company Details

Entity Name: JACKSONVILLE DENTISTRY, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 26 Jan 2021 (5 years ago)
Last Event: CORPORATE MERGER
Event Date Filed: 28 Dec 2023 (2 years ago)
Document Number: L21000048399
FEI/EIN Number 86-1439947
Address: 12058 San Jose Blvd, Jacksonville, FL, 32223, US
Mail Address: 12058 SAN JOSE BLVD, #102, JACKSONVILLE, FL, 32223, US
ZIP code: 32223
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
KELLY PETER Manager 3221 CONWAY RD STE D, ORLANDO, FL, 32812
ROBINSON MATTHEW Agent 3221 CONWAY RD, ORLANDO, FL, 32812

National Provider Identifier

NPI Number:
1417541079
Certification Date:
2021-02-24

Authorized Person:

Name:
PETER KELLY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000086525 MANDARIN DENTAL CARE ACTIVE 2021-06-30 2026-12-31 - 3221 CONWAY RD STE D, ORLANDO, FL, 32832

Events

Event Type Filed Date Value Description
MERGER 2023-12-28 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 100000250571
CHANGE OF PRINCIPAL ADDRESS 2022-01-30 12058 San Jose Blvd, #102, Jacksonville, FL 32223 -

Documents

Name Date
ANNUAL REPORT 2024-03-15
Merger 2023-12-28
ANNUAL REPORT 2023-02-24
ANNUAL REPORT 2022-01-30
Florida Limited Liability 2021-01-26

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Date of last update: 03 Aug 2025

Sources: Florida Department of State