| Entity Name: | IDEAL DENTAL - PEMBROKE PINES PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Jul 2021 (4 years ago) |
| Document Number: | L21000320855 |
| FEI/EIN Number | 87-1870621 |
| Mail Address: | 12750 Merit Dr. Suite 1100, Dallas, TX, 75251, US |
| Address: | 15830 PINES BLVD, PEMBROKE PINES, FL, 33027, US |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992479133 | 2021-08-02 | 2023-05-19 | PO BOX 840925, DALLAS, TX, 752840925, US | 15830 PINES BLVD, PEMBROKE PINES, FL, 330271208, US | |||||||||||||||
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| Phone | +1 972-361-0600 |
| Phone | +1 954-226-5150 |
Authorized person
| Name | MATTHEW DOAN |
| Role | OWNER |
| Phone | 9723318079 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| NRAI SERVICES, INC. | Agent |
| 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 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-01-29 | 15830 PINES BLVD, PEMBROKE PINES, FL 33027 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-03-24 |
| Florida Limited Liability | 2021-07-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
