| Entity Name: | SAGE DENTAL OF ZEPHYRHILLS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Aug 2021 (3 years ago) |
| Document Number: | L21000369494 |
| FEI/EIN Number | 87-2292317 |
| Address: | 6600 Congress Avenue, BOCA RATON, FL, 33487, US |
| Mail Address: | 6600 Congress Avenue, BOCA RATON, FL, 33487, US |
| ZIP code: | 33487 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790456911 | 2021-09-27 | 2021-09-27 | 951 BROKEN SOUND PKWY NW STE 250, BOCA RATON, FL, 334873506, US | 7654 GALL BLVD, ZEPHYRHILLS, FL, 33541, US | |||||||||||||||
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| Phone | +1 561-999-9650 |
| Phone | +1 813-364-5890 |
Authorized person
| Name | CINDY ROARK |
| Role | SVP & CHIEF CLINICAL OFFICER |
| Phone | 5619999650 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Roark Cindy | President | 6600 Congress Avenue, BOCA RATON, FL, 33487 |
| Name | Role |
|---|---|
| SAGE DENTAL GROUP OF FLORIDA, PLLC | Manager |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000107730 | SAGE DENTAL | ACTIVE | 2021-08-19 | 2026-12-31 | No data | 951 BROKEN SOUND PARKWAY, SUITE 250, BOCA RATON, FL, 33487 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-14 | 6600 Congress Avenue, Suite 150, BOCA RATON, FL 33487 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-14 | 6600 Congress Avenue, Suite 150, BOCA RATON, FL 33487 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-03-08 |
| Florida Limited Liability | 2021-08-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
