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IDEAL DENTAL OF WESTCHASE FLORIDA PLLC

Company Details

Entity Name: IDEAL DENTAL OF WESTCHASE FLORIDA PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 17 May 2021 (4 years ago)
Document Number: L21000222012
FEI/EIN Number 86-3961366
Mail Address: 12750 Merit Dr. Suite 1100, Dallas, TX, 75251, US
Address: 10651 SHELDON RD, TAMPA BAY, FL, 33626
ZIP code: 33626
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1467028928 2021-06-03 2023-10-02 PO BOX 840925, DALLAS, TX, 752840925, US 10641 SHELDON RD, TAMPA, FL, 336265114, US

Contacts

Phone +1 972-361-0600
Phone +1 813-849-0003
Fax 8136923592

Authorized person

Name MATTHEW DOAN
Role OWNER
Phone 9723318073

Taxonomy

Taxonomy Code 122300000X - Dentist
Is Primary Yes

Agent

Name Role
NRAI SERVICES, INC. Agent

Member

Name Role Address
DOAN MATTHEW DDS Member 8120 COPPER WAY, DALLAS, TX, 75252
COUSSA JOSHUA DMD Member 8235 W ATLANTIC BLVD, CORAL SPRINGS, FL, 33071

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-01-29 10651 SHELDON RD, TAMPA BAY, FL 33626 No data

Documents

Name Date
ANNUAL REPORT 2024-01-29
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-03-24
Florida Limited Liability 2021-05-17

Date of last update: 01 Feb 2025

Sources: Florida Department of State