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MIDDLEBURG DENTAL PLLC - Florida Company Profile

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Company Details

Entity Name: MIDDLEBURG DENTAL PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 04 Oct 2021 (4 years ago)
Last Event: LC NAME CHANGE
Event Date Filed: 08 Nov 2021 (4 years ago)
Document Number: L21000433977
FEI/EIN Number 87-2961383
Address: 1178 BLANDING BLVD, MIDDLEBURG, FL, 32068
Mail Address: PO BOX 634, PONTE VEDRA BEACH, FL, 32004
ZIP code: 32068
City: Middleburg
County: Clay
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Park Jong yun Auth PO BOX 634, PONTE VEDRA BEACH, FL, 32004
PARK JONG YUN Agent 130 Corridor Rd., Ponte Vedra Beach, FL, 32004

National Provider Identifier

NPI Number:
1528703691
Certification Date:
2023-06-20

Authorized Person:

Name:
JONG YUN PARK
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000050189 ASPEN DENTAL ACTIVE 2022-04-20 2027-12-31 - 281 SANDERS CREEK PARKWAY, EAST SYRACUSE, NY, 13057

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2024-01-04 130 Corridor Rd., PO Box 634, Ponte Vedra Beach, FL 32004 -
LC NAME CHANGE 2021-11-08 MIDDLEBURG DENTAL PLLC -

Documents

Name Date
ANNUAL REPORT 2025-01-20
ANNUAL REPORT 2024-01-04
ANNUAL REPORT 2023-01-18
LC Name Change 2021-11-08
Florida Limited Liability 2021-10-04

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Date of last update: 03 Aug 2025

Sources: Florida Department of State