| Entity Name: | WEST SHERIDAN DENTAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Sep 2021 (3 years ago) |
| Document Number: | L21000397733 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 15641 SHERIDAN STREET, DAVIE, FL, 33331, US |
| Mail Address: | 15641 SHERIDAN STREET, DAVIE, FL, 33331, US |
| ZIP code: | 33331 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992456560 | 2022-01-14 | 2022-01-14 | 15641 SHERIDAN ST STE 400, DAVIE, FL, 333313485, US | 15641 SHERIDAN ST STE 400, DAVIE, FL, 333313485, US | |||||||||||||||||||||||
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| Phone | +1 754-215-4704 |
| Fax | 7864973409 |
Authorized person
| Name | DR. CARLOS F VILLANUEVA |
| Role | DENTIST/MANAGER |
| Phone | 7542154704 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | No |
| Taxonomy Code | 1223P0700X - Prosthodontist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| VILLANUEVA CARLOS | Agent | 15641 SHERIDAN STREET, DAVIE, FL, 33331 |
| Name | Role | Address |
|---|---|---|
| VILLANUEVA CARLOS | Manager | 15641 SHERIDAN STREET, DAVIE, FL, 33331 |
| COHEN FABRIANNE F | Manager | 15641 SHERIDAN STREET, DAVIE, FL, 33331 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000004888 | RENOVA DENTAL AND IMPLANT CENTER | ACTIVE | 2022-01-13 | 2027-12-31 | No data | 15641 SHERIDAN STREET, UNIT 400, DAVIE, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-13 | 15641 SHERIDAN STREET, UNIT 400, DAVIE, FL 33331 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-13 | 15641 SHERIDAN STREET, UNIT 400, DAVIE, FL 33331 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-13 | 15641 SHERIDAN STREET, UNIT 400, DAVIE, FL 33331 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-01-13 |
| Florida Limited Liability | 2021-09-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
